Provider Demographics
NPI:1679808968
Name:TUSHNET, JOE SCOTT
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:SCOTT
Last Name:TUSHNET
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8745 PARTHENIA PL
Mailing Address - Street 2:SUITE 4
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-5166
Mailing Address - Country:US
Mailing Address - Phone:818-895-5002
Mailing Address - Fax:818-895-5502
Practice Address - Street 1:8745 PARTHENIA PL
Practice Address - Street 2:SUITE 4
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-5166
Practice Address - Country:US
Practice Address - Phone:818-895-5002
Practice Address - Fax:818-895-5502
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)