Provider Demographics
NPI:1730661851
Name:ABDELMESSEH, JOSEPH KHEDRY (ACSW)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:KHEDRY
Last Name:ABDELMESSEH
Suffix:
Gender:M
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 W THOUSAND OAKS BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4462
Mailing Address - Country:US
Mailing Address - Phone:805-777-3500
Mailing Address - Fax:
Practice Address - Street 1:125 W. THOUSAND OAKS BLVDS., SUITE 500
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360
Practice Address - Country:US
Practice Address - Phone:805-777-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW102902104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker