Healthcare Provider Details
I. General information
NPI: 1306986625
Provider Name (Legal Business Name): STEVEN HOCHSTADT PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/07/2007
Last Update Date: 04/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1540 E COLORADO ST
GLENDALE CA
91205-1514
US
IV. Provider business mailing address
1540 E COLORADO ST
GLENDALE CA
91205-1514
US
V. Phone/Fax
- Phone: 818-244-7257
- Fax: 818-243-5413
- Phone: 818-244-7257
- Fax: 818-243-5413
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC2200X |
| Taxonomy | Clinical Child & Adolescent Psychologist |
| License Number | PSY14999 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: