Healthcare Provider Details

I. General information

NPI: 1326974031
Provider Name (Legal Business Name): AB PSYCHOTHERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3430 S SEPULVEDA BLVD APT 219
LOS ANGELES CA
90034-6047
US

IV. Provider business mailing address

3430 S SEPULVEDA BLVD APT 219
LOS ANGELES CA
90034-6047
US

V. Phone/Fax

Practice location:
  • Phone: 312-772-1191
  • Fax:
Mailing address:
  • Phone: 323-977-1009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ASHLEY BRADLEY
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PSYD
Phone: 323-977-1009