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General NPI Number Information
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NPI Number | 1548751290
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Entity Type | Organization
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Legal Business Name | TSOLINE KONIALIAN PSYCHOLOGICAL SERVICES, INC.
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Dates
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Enumeration Date | 05/29/2018
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Last Update Date | 09/06/2019
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Provider Practice Location Address
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Address Line | 4519 ROSEMEAD BLVD FL 2
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City | ROSEMEAD
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State | CA
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Zip | 91770
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Country | US
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Telephone | 626-524-2807
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Fax | 818-441-5441
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Provider Business Mailing Address
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Address Line | 4519 ROSEMEAD BLVD FL 2
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City | ROSEMEAD
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State | CA
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Zip | 91770-1476
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Country | US
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Telephone | 626-524-2807
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Fax | 818-441-5441
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Authorized Official
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Title or Position | OPERATIONS MANAGAGER
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Name | DR. JOSEPH VINCENT ANGARELLA
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Credential | PH.D.
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Telephone | 747-389-3197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | PSY19955
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PSY19955
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number | PSY19955
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | PSY19955
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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