Provider Demographics
NPI:1437526738
Name:KURANISHI, MICHELLE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:KURANISHI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17020 CHATSWORTH ST # 1115
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-5844
Mailing Address - Country:US
Mailing Address - Phone:818-452-3161
Mailing Address - Fax:
Practice Address - Street 1:5201 GREAT AMERICA PARKWAY
Practice Address - Street 2:SUITE 320
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95054
Practice Address - Country:US
Practice Address - Phone:818-452-3161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-21
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30465103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist