Healthcare Provider Details
I. General information
NPI: 1740245489
Provider Name (Legal Business Name): A CORPORATE REFERRAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/18/2006
Last Update Date: 01/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3770 MAYFAIR DR
PASADENA CA
91107-2214
US
IV. Provider business mailing address
3770 MAYFAIR DR
PASADENA CA
91107-2214
US
V. Phone/Fax
- Phone: 661-904-0177
- Fax:
- Phone: 661-904-0177
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PSY9584 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | MI5574 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | SPY9584 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
EDWARD
FRANCIS
REED
Title or Position: PRESIDENT
Credential: ED.D.
Phone: 661-904-0177