Healthcare Provider Details

I. General information

NPI: 1053137356
Provider Name (Legal Business Name): ALAN J. GOLIAN, PSY.D., CHILD PSYCHOLOGY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2024
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20750 VENTURA BLVD STE 415
WOODLAND HILLS CA
91364-6205
US

IV. Provider business mailing address

20750 VENTURA BLVD STE 415
WOODLAND HILLS CA
91364-6205
US

V. Phone/Fax

Practice location:
  • Phone: 310-487-4690
  • Fax: 661-426-2952
Mailing address:
  • Phone: 310-487-4690
  • Fax: 661-426-2952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. ALAN J GOLIAN
Title or Position: EXECUTIVE DIRECTOR
Credential: PSY.D.
Phone: 310-487-4690