Healthcare Provider Details

I. General information

NPI: 1972040095
Provider Name (Legal Business Name): WEAL INC A PROFESSIONAL PSYCHOLOGICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 N MADISON AVE STE 707
PASADENA CA
91101-2046
US

IV. Provider business mailing address

65 N MADISON AVE STE 707
PASADENA CA
91101-2046
US

V. Phone/Fax

Practice location:
  • Phone: 626-817-6665
  • Fax:
Mailing address:
  • Phone: 626-817-6665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY28600
License Number StateCA

VIII. Authorized Official

Name: RICHARD LABRIE
Title or Position: PRESIDENT
Credential: PSY.D.
Phone: 626-755-1825