Provider Demographics
NPI:1902008071
Name:KOZINSKI, JOSEPH J (MFT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:J
Last Name:KOZINSKI
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21252 ONAKNOLL DR
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570-9565
Mailing Address - Country:US
Mailing Address - Phone:951-640-0007
Mailing Address - Fax:951-789-0416
Practice Address - Street 1:21252 ONAKNOLL DR
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-9565
Practice Address - Country:US
Practice Address - Phone:951-640-0007
Practice Address - Fax:951-789-0416
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC40693106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist