Active NPI
Christina Savalas Kousakis, MFT
- Clinical Psychologist
- Los Angeles, CA
National Provider Identifier
1902228315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- MFC 48942
- Practice address
- 11340 W Olympic Blvd Ste 210
Los Angeles, CA 90064-1612 - Phone
- (310) 736-5665
- NPI assigned
- Jan 20, 2014
- Last updated
- Jan 20, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | MFC 48942 | CA | Primary |
Addresses
Primary practice location
11340 W Olympic Blvd Ste 210
Los Angeles, CA 90064-1612
Mailing address
11340 W Olympic Blvd Ste 210
Los Angeles, CA 90064-1612
Phone (310) 736-5665
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC 48942 | CA | MD | Clinical Psychologist |
| 48942 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390176000000",
"number": "1902228315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11340 W OLYMPIC BLVD STE 210",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900641612",
"telephone_number": "310-736-5665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11340 W OLYMPIC BLVD STE 210",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900641612",
"telephone_number": "310-736-5665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOUSAKIS",
"first_name": "CHRISTINA",
"middle_name": "SAVALAS",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-20",
"last_updated": "2014-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "MFC 48942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.