Healthcare Provider Details

I. General information

NPI: 1881746733
Provider Name (Legal Business Name): FAMILY PSYCHOLOGICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30495 CANWOOD ST STE 101
AGOURA HILLS CA
91301-4331
US

IV. Provider business mailing address

30495 CANWOOD ST STE 101
AGOURA HILLS CA
91301-4331
US

V. Phone/Fax

Practice location:
  • Phone: 818-707-7366
  • Fax: 818-306-5836
Mailing address:
  • Phone: 818-707-7366
  • Fax: 818-306-5836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. KIM B BARRUS, PH.D.
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 818-707-7366