Healthcare Provider Details

I. General information

NPI: 1265941165
Provider Name (Legal Business Name): ACCENT ON WELLNESS PSYCHOLOGY ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2790 SKYPARK DRIVE 215
TORRANCE CA
90505
US

IV. Provider business mailing address

46 PENINSULA CENTER DRIVE E 379
ROLLING HILLS ESTATES CA
90274
US

V. Phone/Fax

Practice location:
  • Phone: 310-855-3990
  • Fax: 424-276-7676
Mailing address:
  • Phone: 310-855-3990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number26003
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number26003
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number26003
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number26003
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number26003
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number26003
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number26003
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number26003
License Number StateCA
# 9
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number26003
License Number StateCA

VIII. Authorized Official

Name: DR. DANIEL ERNESTO BRUZZONE
Title or Position: PRESIDENT
Credential: PSYCHOLOGIST
Phone: 310-855-3990