Provider Demographics
NPI:1467618793
Name:KAWA, ALLISON VICTORIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:VICTORIA
Last Name:KAWA
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 1:12381 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1063
Mailing Address - Country:US
Mailing Address - Phone:310-387-2888
Mailing Address - Fax:310-571-4129
Practice Address - Street 1:12381 WILSHIRE BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1063
Practice Address - Country:US
Practice Address - Phone:310-387-2888
Practice Address - Fax:310-571-4129
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2010-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 23700103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent