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General NPI Number Information
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NPI Number | 1417350430
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Entity Type | Organization
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Legal Business Name | STEPHANIE L. DAVIDSON, PSY.D., A PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 10/04/2014
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 5158 CLARETON DR UNIT 481
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City | AGOURA HILLS
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State | CA
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Zip | 91376-7030
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Country | US
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Telephone | 805-405-6945
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Fax |
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Provider Business Mailing Address
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Address Line | 5743 CORSA AVE STE 221
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-6451
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Country | US
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Telephone | 805-405-6945
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Fax | 805-426-8868
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEPHANIE DAVIDSON
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Credential | PSY.D.
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Telephone | 805-405-6945
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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 | PSY24540
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License Number State | CA
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