KELLIE DEFAZIO (NPI# 1275044554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275044554 |
| Entity Type | Individual |
| Full Name | KELLIE DEFAZIO |
| Credential | BA |
| Practice Address |
31344 Via Colinas Ste 108 Westlake Village CA 91362-6797 |
| Practice Telephone | 8053793212 |
| Mailing Telephone | 8053793212 |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2017-10-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| THE HOLMAN GROUP | 45-3589857 | 01 |
| Street Address |
31344 VIA COLINAS STE 108 |
| City | WESTLAKE VILLAGE |
| State | CA |
| Zip Code | 91362-6797 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164762068 | Rebecca Lynn Cox | Behavioral Analyst | 31344 Via Colinas Ste 108, Westlake Village, CA 91362 | 2013-03-01 |
| 1073024253 | Daniel David | Behavioral Analyst | 31344 Via Colinas Ste 108, Westlake Village, CA 91362-6797 | 2017-10-16 |
| 1780195925 | Zaira Lopez | Behavioral Analyst | 31344 Via Colinas Ste 108, Westlake Village, CA 91362-6797 | 2017-10-16 |
| 1063923241 | Ana Lopez | Behavioral Analyst | 31344 Via Colinas Ste 108, Westlake Village, CA 91362-6797 | 2017-10-16 |
| 1043721327 | Kacie Marczuk | Behavioral Analyst | 31344 Via Colinas Ste 108, Westlake Village, CA 91362-6797 | 2017-10-13 |
| 1366953648 | Sarah Awana | Behavioral Analyst | 31344 Via Colinas Ste 108, Westlake Village, CA 91362-6797 | 2017-10-13 |
| 1275044638 | Sofia Farid | Behavioral Analyst | 31344 Via Colinas Ste 108, Westlake Village, CA 91362-6797 | 2017-10-12 |
| 1316458797 | Marc Youkel | Behavioral Analyst | 31344 Via Colinas Ste 108, Westlake Village, CA 91362-6797 | 2017-10-12 |
| 1639680093 | Maria De La Luz Cordova Gama | Behavioral Analyst | 31344 Via Colinas Ste 108, Westlake Village, CA 91362-6797 | 2017-10-12 |
| 1538679980 | Silvana Good | Behavioral Analyst | 31344 Via Colinas Ste 108, Westlake Village, CA 91362-6797 | 2017-10-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538624200 | Scott Myers | Physical Therapist | 1145 Lindero Canyon Rd Ste D7, Thousand Oaks, CA 91362 | 2019-02-06 |
| 1366940827 | Kevin A Attaie Pharmaceutical, Inc | Pharmacy | 2945 Townsgate Rd., Suite 200, Westlake Village, CA 91362 | 2018-01-30 |
| 1497294953 | Tiffany Shah | Marriage & Family Therapist | 128 Auburn Ct Ste 106, Westlake Village, CA 91362 | 2017-02-16 |
| 1538604913 | Robin Sakakini | Psychologist | 31255 Cedar Valley Road, Westlake Village, CA 91362 | 2016-12-21 |
| 1851843858 | Trusted Family Homecare | In Home Supportive Care | 1429 E Thousand Oaks Blvd Ste 201, Thousand Oaks, CA 91362 | 2016-10-26 |
| 1396191896 | Andrey Rossius Dds Inc | Dentist | 3665 East Thousand Oaks Blvd, Westlake Village, CA 91362 | 2016-05-13 |
| 1497130462 | Jennifer Kopczynski | Marriage & Family Therapist | 4035 E Thousand Oaks Blvd Ste 100, Westlake Village, CA 91362 | 2015-07-20 |
| 1588057335 | Allison Lieberman | Marriage & Family Therapist | 31194 La Baya Dr Ste 202, Westlake Village, CA 91362 | 2015-03-17 |
| 1427449586 | Natalie Mondschein | Massage Therapist | 128 Auburn Court, Suite 100, Westlake Village, CA 91362 | 2015-02-11 |
| 1891193538 | Rylist, Inc. | Substance Abuse Rehabilitation Facility | 1154 Cardiff Cir, Thousand Oaks, CA 91362 | 2014-12-11 |
| Find all providers in zip 91362 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356805469 | Cassandra Lemons Bowles | Psychologist | 31200 Via Colinas Ste 100, Westlake Village, CA 91362-3950 | 2019-01-23 |
| 1952888943 | Richard Riemer | Psychologist | 3625 E Thousand Oaks Blvd Ste 175, Westlake Village, CA 91362-3563 | 2018-07-23 |
| 1225529043 | Kenneth Steven Gordon | Psychologist | 755 Lakefield Rd Ste J, Westlake Village, CA 91361-2639 | 2018-05-29 |
| 1104254770 | Suzanne Mary Corwin | Psychologist | 31666 Foxfield Dr, Westlake Village, CA 91361-4714 | 2013-10-17 |
| 1639438047 | Alison Maria Magoun Moreno | Psychologist | 30961 Agoura Rd Ste 217, Westlake Village, CA 91361-5619 | 2012-05-07 |
| 1992075386 | Danielle Selvin Harris | Psychologist | 3625 E Thousand Oaks Blvd Ste 209, Westlake Village, CA 91362-3566 | 2012-01-03 |
| 1982830188 | Kris Sourbeer | Psychologist | 2239 Townsgate Rd # 217, Westlake Village, CA 91361-2405 | 2009-06-03 |
| 1164614285 | Olivia Manopelli Moura-thakkar | Psychologist | 3304 Blue Ridge Ct, Westlake Village, CA 91362-3521 | 2007-08-13 |
| 1306041058 | Thomas F Locke | Psychologist | 3625 E Thousand Oaks Blvd Ste 109, Westlake Village, CA 91362-3551 | 2007-06-20 |
| 1265552335 | Michele Harway | Psychologist | 4165 E Thousand Oaks Blvd Ste 345, Westlake Village, CA 91362-7224 | 2007-03-30 |
| Find all providers in WESTLAKE VILLAGE | ||||
| City | WESTLAKE VILLAGE |
| Zip Code | 91362 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.