Healthcare Provider Details

I. General information

NPI: 1508052002
Provider Name (Legal Business Name): JENNIFER POND, PSY.D., A PSYCHOLOGICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 09/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4505 LAS VIRGENES RD SUITE 217
CALABASAS CA
91302-1956
US

IV. Provider business mailing address

4505 LAS VIRGENES RD SUITE 217
CALABASAS CA
91302-1956
US

V. Phone/Fax

Practice location:
  • Phone: 818-888-3408
  • Fax: 818-878-0102
Mailing address:
  • Phone: 818-888-3408
  • Fax: 818-878-0102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JENNIFER POND
Title or Position: PRESIDENT
Credential: PSY.D.
Phone: 818-888-3408