Healthcare Provider Details

I. General information

NPI: 1891844643
Provider Name (Legal Business Name): CALIFORNIA PSYCHOLOGICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 02/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16311 VENTURA BLVD. SUITE 1050
ENCINO CA
91436
US

IV. Provider business mailing address

P.O. BOX 4368
VALLEY VILLAGE CA
91617
US

V. Phone/Fax

Practice location:
  • Phone: 818-752-3330
  • Fax: 818-508-4820
Mailing address:
  • Phone: 818-752-3330
  • Fax: 818-508-4820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. BARRY A. HALOTE
Title or Position: OWNER
Credential: PH. D.
Phone: 818-752-3330