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General NPI Number Information
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NPI Number | 1336609189
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Entity Type | Organization
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Legal Business Name | PSYCHOTHERAPY CENTER FOR HEALING AND PERSONAL GROWTH
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 2001 S. BARINGTON AVE SUITE 222
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City | LOS ANGELES
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State | CA
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Zip | 90025
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Country | US
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Telephone | 310-991-9616
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 S. BARINGTON AVE SUITE 222
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City | LOS ANGELES
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State | CA
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Zip | 90025
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Country | US
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Telephone | 310-991-9616
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | MRS. RONIT FARZAM
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Credential | PHD.
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Telephone | 310-991-9616
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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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Taxonomy #2
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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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