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NPI 1609373786

NPI 1609373786 : INSIGHT PSYCHOLOGY GROUP INC : LOS ANGELES, CA

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General NPI Number Information
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    NPI Number           |    1609373786
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    Entity Type          |    Organization 
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    Legal Business Name  |    INSIGHT PSYCHOLOGY GROUP INC 
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Dates
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    Enumeration Date     |    04/06/2018
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    Last Update Date     |    04/06/2018
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Provider Practice Location Address
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    Address Line         |    6100 CENTER DR FL 5 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90045-9206
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    Country              |    US
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    Telephone            |    818-925-8559
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 491724 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90049-8724
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    DR. HENGAMEH  MAHGEREFTEH 
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    Credential           |    PSY.D.
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    Telephone            |    818-925-8559
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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       |    
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    License Number State |    
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