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General NPI Number Information
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NPI Number | 1124359617
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Entity Type | Individual
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Provider Name | HERB GLAZEROFF PH.D.
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Gender | Male
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Dates
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Enumeration Date | 01/22/2010
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Last Update Date | 01/22/2010
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Provider Practice Location Address
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Address Line | 480 N INDIAN HILL BLVD SUITE 1A
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City | CLAREMONT
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State | CA
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Zip | 91711-4615
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Country | US
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Telephone | 909-621-2023
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Fax |
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Provider Business Mailing Address
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Address Line | 835 LOCUST AVE UNIT 426
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City | LONG BEACH
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State | CA
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Zip | 90813-4313
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Country | US
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Telephone | 562-606-2281
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PSY 16117
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License Number State | CA
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