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General NPI Number Information
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NPI Number | 1093643439
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Entity Type | Organization
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Legal Business Name | DR. STACI WOLD PSYCHOLOGICAL SERVICES CORPORATION
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Dates
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Enumeration Date | 05/13/2026
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Last Update Date | 05/13/2026
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Provider Practice Location Address
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Address Line | 6345 BALBOA BLVD STE 212
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City | ENCINO
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State | CA
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Zip | 91316-1517
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Country | US
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Telephone | 818-968-1215
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Fax |
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Provider Business Mailing Address
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Address Line | 6345 BALBOA BLVD STE 212
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City | ENCINO
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State | CA
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Zip | 91316-1517
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Country | US
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Telephone | 818-968-1215
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | STACI WOLD
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Credential | PSYD
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Telephone | 818-968-1215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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