Provider Demographics
NPI:1316975717
Name:CASCIANI, JOSEPH MICHAEL (PHD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:CASCIANI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4901 MORENA BLVD
Mailing Address - Street 2:STE 109
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-3423
Mailing Address - Country:US
Mailing Address - Phone:858-272-3992
Mailing Address - Fax:858-272-3804
Practice Address - Street 1:4901 MORENA BLVD
Practice Address - Street 2:STE 109
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-3423
Practice Address - Country:US
Practice Address - Phone:858-272-3992
Practice Address - Fax:858-272-3804
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY5291103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical