Provider Demographics
NPI:1578728663
Name:CLOUSE, LANIKAI N (PSYD)
Entity Type:Individual
Prefix:
First Name:LANIKAI
Middle Name:N
Last Name:CLOUSE
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 1:4335 VAN NUYS BLVD STE 435
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-3727
Mailing Address - Country:US
Mailing Address - Phone:626-585-0041
Mailing Address - Fax:626-585-1839
Practice Address - Street 1:2810 E DEL MAR BLVD STE 12
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-6709
Practice Address - Country:US
Practice Address - Phone:626-585-0041
Practice Address - Fax:626-585-1839
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21918103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist