Individual
ALEXANDRA LILLIAN KUSSIN-SHOPTAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
13400 RIVERSIDE DR STE 318, SHERMAN OAKS, CA 91423-2501
(323) 418-2103
Mailing address
13400 RIVERSIDE DR STE 318, SHERMAN OAKS, CA 91423-2501
(323) 418-2103
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
PSY30547
CA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY30547
CA
103TF0000X
Family Psychologist
PSY30547
CA
103TH0100X
Health Service Psychologist
PSY30547
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/18/2011
Last updated
07/01/2021
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