Individual
CARISSA GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26565 AGOURA RD STE 200, CALABASAS, CA 91302-1990
(310) 692-4115
Mailing address
26565 AGOURA RD STE 200, CALABASAS, CA 91302-1990
(310) 692-4115
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
30196
CA
Other
Enumeration date
10/07/2014
Last updated
05/01/2024
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