Individual
ANDREA LYNN KALOUSTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5901 E 7TH ST, LONG BEACH, CA 90822-5201
(562) 826-8000
Mailing address
2031 VALLEJO DR, TUSTIN, CA 92782-8619
(949) 705-6485
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
40577
TX
1041C0700X
Clinical Social Worker
6801071450
MI
1041C0700X
Clinical Social Worker
Primary
82531
CA
Other
Enumeration date
11/04/2018
Last updated
11/04/2018
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