Provider Demographics
NPI:1912636697
Name:SASHA KASSAI PSYCHOLOGY INC
Entity type:Organization
Organization Name:SASHA KASSAI PSYCHOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHABNAM
Authorized Official - Middle Name:SASHA
Authorized Official - Last Name:KASSAI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:310-985-5846
Mailing Address - Street 1:3406 VIA LIDO STE 1A377
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3961
Mailing Address - Country:US
Mailing Address - Phone:310-985-5846
Mailing Address - Fax:
Practice Address - Street 1:3406 VIA LIDO STE 1A377
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3961
Practice Address - Country:US
Practice Address - Phone:310-985-5846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty