Provider Demographics
NPI:1275387961
Name:KUSKO, VAUGHAN (PPS, MS, CAS, EDD)
Entity Type:Individual
Prefix:DR
First Name:VAUGHAN
Middle Name:
Last Name:KUSKO
Suffix:
Gender:F
Credentials:PPS, MS, CAS, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 E CITRUS AVE
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-5325
Mailing Address - Country:US
Mailing Address - Phone:909-307-5500
Mailing Address - Fax:
Practice Address - Street 1:840 E CITRUS AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-5325
Practice Address - Country:US
Practice Address - Phone:909-307-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool