Provider Demographics
NPI:1932656162
Name:JOSEPH, CHARI (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHARI
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:CHARI
Other - Middle Name:
Other - Last Name:BONDURANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8601 LINCOLN BLVD STE 180-592
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-3554
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8601 LINCOLN BLVD STE 180-592
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-3554
Practice Address - Country:US
Practice Address - Phone:424-571-9508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225C00000X
CAPSY31546103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor