Provider Demographics
NPI:1861732141
Name:ALLISON KAWA, PSY.D. & ASSOCIATES, A PSYCHOLOGICAL CORPORATION
Entity type:Organization
Organization Name:ALLISON KAWA, PSY.D. & ASSOCIATES, A PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:KAWA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:310-387-2888
Mailing Address - Street 1:12381 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1063
Mailing Address - Country:US
Mailing Address - Phone:310-387-2888
Mailing Address - Fax:310-820-7970
Practice Address - Street 1:12381 WILSHIRE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1063
Practice Address - Country:US
Practice Address - Phone:310-387-2888
Practice Address - Fax:310-820-7970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23700103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty