Healthcare Provider Details

I. General information

NPI: 1629301676
Provider Name (Legal Business Name): RICHARD OELBERGER, PHD PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2009
Last Update Date: 09/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

292 S LA CIENEGA BLVD SUITE 400/ PHC
BEVERLY HILLS CA
90211-3330
US

IV. Provider business mailing address

292 S LA CIENEGA BLVD SUITE 400/ PHC
BEVERLY HILLS CA
90211-3330
US

V. Phone/Fax

Practice location:
  • Phone: 310-490-6733
  • Fax:
Mailing address:
  • Phone: 310-490-6733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY 22186
License Number StateCA

VIII. Authorized Official

Name: DR. RICHARD OELBERGER
Title or Position: PSYCHOLOGIST
Credential: PHD
Phone: 310-490-6733