Healthcare Provider Details

I. General information

NPI: 1508176256
Provider Name (Legal Business Name): OREN BOXER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2010
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 FAIR OAKS AVE STE 101
SOUTH PASADENA CA
91030-2685
US

IV. Provider business mailing address

625 FAIR OAKS AVE STE 101
SOUTH PASADENA CA
91030-2685
US

V. Phone/Fax

Practice location:
  • Phone: 626-765-4482
  • Fax:
Mailing address:
  • Phone: 626-765-4482
  • Fax: 888-887-6256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPSY 24357
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 24357
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: