Provider Demographics
NPI:1477744589
Name:KAWAJA, JOSEPH (MS)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:KAWAJA
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 S GLASSELL ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-1919
Mailing Address - Country:US
Mailing Address - Phone:714-633-0403
Mailing Address - Fax:866-672-5668
Practice Address - Street 1:369 S GLASSELL ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-1919
Practice Address - Country:US
Practice Address - Phone:714-633-0403
Practice Address - Fax:866-672-5668
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 9335106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist