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General NPI Number Information
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NPI Number | 1386182046
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Entity Type | Organization
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Legal Business Name | CHANTEL CORTINOVIS, PSY.D., A PROFESSIONAL PSYCHOLOGY CORPORATION
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 02/02/2017
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Provider Practice Location Address
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Address Line | 1081 WESTWOOD BLVD SUITE 221
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City | LOS ANGELES
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State | CA
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Zip | 90024-2911
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Country | US
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Telephone | 323-250-2461
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Fax |
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Provider Business Mailing Address
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Address Line | 1081 WESTWOOD BLVD SUITE 221
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City | LOS ANGELES
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State | CA
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Zip | 90024-2911
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Country | US
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Telephone | 323-250-2461
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Fax |
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Authorized Official
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Title or Position | CEO, OWNER
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Name | DR. CHANTEL CORTINOVIS
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Credential | PSY.D.
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Telephone | 323-250-2461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | PSY28895
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License Number State | CA
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