Healthcare Provider Details

I. General information

NPI: 1154566438
Provider Name (Legal Business Name): JOEL O'BESO PSY. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOEL OBESO-MALDONADO PSY. D.

II. Dates (important events)

Enumeration Date: 12/15/2008
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6230 WILSHIRE BLVD STE 540
LOS ANGELES CA
90048-5126
US

IV. Provider business mailing address

6230 WILSHIRE BLVD STE 540
LOS ANGELES CA
90048-5126
US

V. Phone/Fax

Practice location:
  • Phone: 714-525-8509
  • Fax:
Mailing address:
  • Phone: 714-525-8509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY34448
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: