Healthcare Provider Details

I. General information

NPI: 1366962581
Provider Name (Legal Business Name): PAULA E. BRUCE, PH.D. & ASSOCIATES, A PSYCHOLOGICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9350 WILSHIRE BLVD STE 212
BEVERLY HILLS CA
90212-3204
US

IV. Provider business mailing address

9350 WILSHIRE BLVD STE 212
BEVERLY HILLS CA
90212-3204
US

V. Phone/Fax

Practice location:
  • Phone: 310-271-2275
  • Fax: 310-271-2275
Mailing address:
  • Phone: 310-271-2275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. PAULA E BRUCE
Title or Position: CEO
Credential: PH.D.
Phone: 310-271-2275