Healthcare Provider Details
I. General information
NPI: 1427838655
Provider Name (Legal Business Name): THERAPY WHEREVER YOU ARE, A PSYCHOLOGICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/04/2023
Last Update Date: 12/28/2023
Certification Date: 12/28/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
955 DEEP VALLEY DR UNIT 3773
PALOS VERDES PENINSULA CA
90274-3125
US
IV. Provider business mailing address
PO BOX 3773
PALOS VERDES PENINSULA CA
90274-9528
US
V. Phone/Fax
- Phone: 310-845-6335
- Fax:
- Phone: 484-515-1743
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RAINA
MOOSA
Title or Position: CORPORATION OWNER
Credential: PSYD
Phone: 310-845-6335