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General NPI Number Information
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NPI Number | 1619846862
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Entity Type | Organization
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Legal Business Name | AMBROSIA PSYCHOLOGY INC
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 2444 WILSHIRE BLVD STE 202
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City | SANTA MONICA
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State | CA
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Zip | 90403-5810
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Country | US
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Telephone | 323-732-8699
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Fax |
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Provider Business Mailing Address
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Address Line | 11740 SAN VICENTE BLVD STE 109-316
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City | LOS ANGELES
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State | CA
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Zip | 90049-6610
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Country | US
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Telephone | 323-732-8699
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELISABETTA AMBROSIA
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Credential |
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Telephone | 818-732-8699
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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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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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