Healthcare Provider Details

I. General information

NPI: 1003972209
Provider Name (Legal Business Name): LOUIS MEAUX PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 E COLORADO BLVD 406
PASADENA CA
91101-2039
US

IV. Provider business mailing address

1246 N CEDAR ST
GLENDALE CA
91207-1427
US

V. Phone/Fax

Practice location:
  • Phone: 626-568-0852
  • Fax:
Mailing address:
  • Phone: 818-241-1769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY10153
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: