Pch Treatment | |
11965 Venice Blvd Suite 407 Los Angeles CA 90066-3979 | |
(310) 566-7625 | |
(310) 566-7629 |
Full Name | Pch Treatment |
---|---|
Speciality | Psychologist - Group Psychotherapy |
Location | 11965 Venice Blvd, Los Angeles, California |
Authorized Official Name and Position | Jeffery Ball (EXECUTIVE AND CLINICAL DIRECTOR) |
Authorized Official Contact | 3105718040 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Pch Treatment 11965 Venice Blvd Suite 407 Los Angeles CA 90066-3979 Ph: (310) 566-7625 | Pch Treatment 11965 Venice Blvd Suite 407 Los Angeles CA 90066-3979 Ph: (310) 566-7625 |
NPI Number | 1003135906 |
---|---|
Provider Enumeration Date | 05/18/2010 |
Last Update Date | 05/18/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003135906 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TP2701X | Psychologist - Group Psychotherapy | (* (Not Available)) | Primary |
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