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General NPI Number Information
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NPI Number | 1427836048
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Entity Type | Organization
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Legal Business Name | CENTER FOR INTEGRATIVE NEURODEVELOPMENT PSYCHOLOGICAL SERVICES, P.C.
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Dates
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Enumeration Date | 09/15/2023
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Last Update Date | 09/15/2023
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Provider Practice Location Address
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Address Line | 333 RICHMOND ST
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City | EL SEGUNDO
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State | CA
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Zip | 90245-3730
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Country | US
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Telephone | 312-505-9243
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Fax |
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Provider Business Mailing Address
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Address Line | 333 RICHMOND ST
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City | EL SEGUNDO
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State | CA
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Zip | 90245-3730
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Country | US
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Telephone | 312-505-9243
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Fax |
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Authorized Official
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Title or Position | PH.D.
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Name | DR. APRIL CARBONE
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Credential | PH.D.
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Telephone | 312-505-9243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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