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General NPI Number Information
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NPI Number | 1669898797
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Entity Type | Organization
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Legal Business Name | SUSAN SAXE-CLIFFORD, PH.D. APC
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Dates
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Enumeration Date | 03/13/2014
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Last Update Date | 03/13/2014
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Provider Practice Location Address
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Address Line | 16530 VENTURA BLVD STE 203
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City | ENCINO
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State | CA
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Zip | 91436-4535
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Country | US
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Telephone | 818-788-8005
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Fax | 818-788-8544
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Provider Business Mailing Address
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Address Line | 16530 VENTURA BLVD STE 203
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City | ENCINO
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State | CA
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Zip | 91436-4535
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Country | US
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Telephone | 818-788-8005
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Fax | 818-788-8544
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUSAN SAXE-CLIFFORD
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Credential | PH.D.
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Telephone | 818-788-8005
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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 | PSY4923
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License Number State | CA
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