Provider Demographics
NPI:1033423306
Name:CSUKAY, ORKIDEH (PSY D)
Entity Type:Individual
Prefix:DR
First Name:ORKIDEH
Middle Name:
Last Name:CSUKAY
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:A PSYCHOLOGICAL
Other - Middle Name:
Other - Last Name:CORPORATION
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:18305 SHERMAN WAY
Mailing Address - Street 2:31
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4425
Mailing Address - Country:US
Mailing Address - Phone:818-254-9794
Mailing Address - Fax:818-462-8171
Practice Address - Street 1:18305 SHERMAN WAY
Practice Address - Street 2:31
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4425
Practice Address - Country:US
Practice Address - Phone:818-294-9794
Practice Address - Fax:818-462-8171
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-29
Last Update Date:2014-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23559103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEZ982AOtherMEDICARE PTAN