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NPI Code Detail

MEDICARE: SACHA MIRAN BOLLAS

MEDICARE: SACHA MIRAN BOLLAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TB0200XCognitive & Behavioral PsychologistPSY28063CA
2103TC2200XClinical Child & Adolescent PsychologistPSY28063CA
3103TP0814XPsychoanalysis PsychologistPSY28063CA
4103TC0700XClinical PsychologistPSY28063CA

General Provider Information

NPI Number : 1225506900
Entity Type Code : Individual
Provider Name (Legal Business Name) : SACHA MIRAN BOLLAS
Provider Business Mailing Address
First Line : 3786 BEETHOVEN ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90066-3536
Country : US
Telephone Number : 310-741-7408
Fax Number :
Provider Business Practice Location Address
First Line : 1990 S BUNDY DR STE 320
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-5249
Country : US
Telephone Number : 310-741-7408
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2018
Last Update Date : 05/13/2025

Similar Medicare Providers

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Practice Location Address:
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1023366721 — DR. MATTHEW HEPNER RYAN PH.D.
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1679060669 — COMMUNITY WEST LLC
Practice Location Address:
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LOS ANGELES, CA
90025-5249
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Practice Fax:
1326512625 — DR. DANA KLINE PHD
Practice Location Address:
1990 S BUNDY DR STE 320
LOS ANGELES, CA
90025-5249
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Practice Fax:
1801424742 — SACHA BOLLAS PSYD, INC.
Practice Location Address:
1990 S BUNDY DR STE 320
LOS ANGELES, CA
90025-5249
Practice Phone: 310-741-7408
Practice Fax:
1124605191 — GABRIEL BACH LMFT
Practice Location Address:
1990 S BUNDY DR STE 320
LOS ANGELES, CA
90025-5249
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Practice Fax:

Directions to “ SACHA MIRAN BOLLAS ” Practice Location

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