Healthcare Provider Details

I. General information

NPI: 1639013980
Provider Name (Legal Business Name): THRESHOLD PSYCHOLOGY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3231 OCEAN PARK BLVD STE 122
SANTA MONICA CA
90405-3231
US

IV. Provider business mailing address

3231 OCEAN PARK BLVD STE 122
SANTA MONICA CA
90405-3231
US

V. Phone/Fax

Practice location:
  • Phone: 323-445-5765
  • Fax:
Mailing address:
  • Phone: 310-626-4789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. MARY BARBOUR
Title or Position: SECRETARY
Credential: LMFT
Phone: 323-445-5765