Healthcare Provider Details

I. General information

NPI: 1699029306
Provider Name (Legal Business Name): ASSESSMENT, CONSULTATION & TREATMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2012
Last Update Date: 12/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 EAST FOOTHILL BLVD. SUITE 100
PASADENA CA
91107-7100
US

IV. Provider business mailing address

2700 EAST FOOTHILL BLVD. SUITE 100
PASADENA CA
91107-7100
US

V. Phone/Fax

Practice location:
  • Phone: 626-824-0982
  • Fax: 888-717-7674
Mailing address:
  • Phone: 626-824-0982
  • Fax: 888-717-7674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBACB1073918
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY25243
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberPSY25243
License Number StateCA

VIII. Authorized Official

Name: DR. PAULA MARIE SANTOS
Title or Position: PROPRIETOR
Credential: PSY.D., BCBA-D
Phone: 626-824-0982