Healthcare Provider Details

I. General information

NPI: 1578458071
Provider Name (Legal Business Name): ABBA CENTER, PSYCHOLOGICAL SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 06/12/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 DEEP VALLEY DR STE 200
ROLLING HILLS ESTATES CA
90274-3614
US

IV. Provider business mailing address

609 DEEP VALLEY DR STE 200
ROLLING HILLS ESTATES CA
90274-3614
US

V. Phone/Fax

Practice location:
  • Phone: 323-494-3762
  • Fax:
Mailing address:
  • Phone: 323-494-3762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. DORIBETH MARIA ADAMS TARDILLO
Title or Position: CORPORATE OFFICERS, DIRECTOR
Credential: PSY.D.
Phone: 323-494-3762