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General NPI Number Information
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NPI Number | 1477806818
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Entity Type | Organization
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Legal Business Name | JOHN GEIRLAND PH.D. PSYCHOTHERAPY CORPORATION
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Dates
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Enumeration Date | 10/23/2012
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Last Update Date | 10/23/2012
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Provider Practice Location Address
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Address Line | 4444 W RIVERSIDE DR STE 305
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City | BURBANK
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State | CA
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Zip | 91505-4048
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Country | US
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Telephone | 747-333-8148
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Fax |
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Provider Business Mailing Address
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Address Line | 4335 BECK AVE
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City | STUDIO CITY
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State | CA
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Zip | 91604-2806
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Country | US
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Telephone | 747-333-8148
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DR. JOHN GUIDO GEIRLAND
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Credential | PH.D.
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Telephone | 747-333-8148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number | PSY25197
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | PSY25197
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY25197
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY25197
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License Number State | CA
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