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General NPI Number Information
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NPI Number | 1467490987
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Entity Type | Individual
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Provider Name | PATRICIA K MASUDA-STORY PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 09/03/2016
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Provider Practice Location Address
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Address Line | 100 N BRAND BLVD SUITE 316
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City | GLENDALE
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State | CA
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Zip | 91203-2641
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Country | US
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Telephone | 818-561-0531
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Fax | 800-976-0803
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Provider Business Mailing Address
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Address Line | 17328 VENTURA BLVD #134
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City | ENCINO
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State | CA
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Zip | 91316-3904
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Country | US
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Telephone | 818-561-0531
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY20385
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY2973
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | PSY20385
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | PSY20385
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number | PSY 20385
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number | PSY 20385
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License Number State | CA
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