Healthcare Provider Details

I. General information

NPI: 1528080645
Provider Name (Legal Business Name): PFUSION PSYCHOLOGICAL SER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 09/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

337 S BEVERLY DR 107
BEVERLY HILLS CA
90212-4315
US

IV. Provider business mailing address

337 S BEVERLY DR 107
BEVERLY HILLS CA
90212-4315
US

V. Phone/Fax

Practice location:
  • Phone: 310-552-8050
  • Fax: 310-552-8052
Mailing address:
  • Phone: 310-552-8050
  • Fax: 310-552-8052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: RONALD LOUIS KAUFMAN
Title or Position: CEO
Credential: PSYD
Phone: 310-552-8050