Healthcare Provider Details

I. General information

NPI: 1932223435
Provider Name (Legal Business Name): JOSEPH R. VENEMA PH.D. A PSYCHOLOGICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 E COLORADO BLVD SUITE 530
PASADENA CA
91101-2039
US

IV. Provider business mailing address

595 E COLORADO BLVD SUITE 530
PASADENA CA
91101-2039
US

V. Phone/Fax

Practice location:
  • Phone: 626-405-0978
  • Fax: 626-405-1948
Mailing address:
  • Phone: 626-405-0978
  • Fax: 626-405-1948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY3770
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPSY9963
License Number StateCA

VIII. Authorized Official

Name: DR. JOSEPH RICHARD VENEMA
Title or Position: OWNER
Credential: PH.D.
Phone: 626-405-0978