Healthcare Provider Details

I. General information

NPI: 1932824943
Provider Name (Legal Business Name): ONWARD PSYCHOLOGY A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2022
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16530 VENTURA BLVD STE 400
ENCINO CA
91436-4551
US

IV. Provider business mailing address

11901 SANTA MONICA BLVD # 703
LOS ANGELES CA
90025-2767
US

V. Phone/Fax

Practice location:
  • Phone: 424-209-8143
  • Fax:
Mailing address:
  • Phone: 424-209-8143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: ROSALITA BENEDICTO
Title or Position: OWNER/CLINICAL PSYCHOLOGIST
Credential: PHD
Phone: 424-209-8143