Provider Demographics
NPI:1821298548
Name:KUUSINEN, MARCELA V (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARCELA
Middle Name:V
Last Name:KUUSINEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MRS
Other - First Name:MARCELA
Other - Middle Name:VARGAS
Other - Last Name:KUUSINEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 609001
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92160-9001
Mailing Address - Country:US
Mailing Address - Phone:619-528-4600
Mailing Address - Fax:619-528-4625
Practice Address - Street 1:221 W CREST ST STE 102
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-1736
Practice Address - Country:US
Practice Address - Phone:760-489-4930
Practice Address - Fax:760-489-4933
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY28955103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW416Medicare PIN