=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699077552
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HALLE M. ATEN, PH.D., A PSYCHOLOGICAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/29/2010
-----------------------------------------------------
Last Update Date | 11/29/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6310 SAN VICENTE BLVD SUITE 401
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90048-5426
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-339-2546
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6310 SAN VICENTE BLVD SUITE 401
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90048-5426
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-339-2546
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PSYCHOLOGIST
-----------------------------------------------------
Name | DR. HALLE M ATEN
-----------------------------------------------------
Credential | PH.D.
-----------------------------------------------------
Telephone | 310-339-2546
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | PSY 22348
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------