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General NPI Number Information
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NPI Number | 1063236222
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Entity Type | Organization
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Legal Business Name | SOCIAL SCHOLARS LICENSED EDUCATIONAL PSYCHOLOGY INC.
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 16200 VENTURA BLVD STE 215
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City | ENCINO
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State | CA
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Zip | 91436-4647
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Country | US
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Telephone | 818-208-9874
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Fax |
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Provider Business Mailing Address
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Address Line | 16200 VENTURA BLVD STE 215
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City | ENCINO
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State | CA
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Zip | 91436-4647
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Country | US
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Telephone | 818-208-9874
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Fax | 818-764-7575
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. DANA JACOBSON
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Credential | LEP
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Telephone | 818-448-5788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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