Healthcare Provider Details

I. General information

NPI: 1124718853
Provider Name (Legal Business Name): TALK THERAPY PSYCHOLOGICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 05/08/2023
Certification Date: 05/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 N BELLFLOWER BLVD STE 205
LONG BEACH CA
90815-4020
US

IV. Provider business mailing address

1777 N BELLFLOWER BLVD STE 205
LONG BEACH CA
90815-4020
US

V. Phone/Fax

Practice location:
  • Phone: 310-383-0062
  • Fax:
Mailing address:
  • Phone: 310-383-0062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. LESLIE DAVIS
Title or Position: CEO
Credential:
Phone: 310-383-0062