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General NPI Number Information
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NPI Number | 1699240952
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Entity Type | Organization
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Legal Business Name | THRIVE PSYCHOLOGY PRACTICE, INC.
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Dates
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Enumeration Date | 10/12/2018
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Last Update Date | 07/30/2019
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Provider Practice Location Address
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Address Line | 10646 ZELZAH AVE STE 207
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City | GRANADA HILLS
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State | CA
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Zip | 91344-5959
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Country | US
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Telephone | 818-669-4526
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Fax |
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Provider Business Mailing Address
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Address Line | 1137 N ISABEL ST
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City | GLENDALE
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State | CA
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Zip | 91207-1748
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Country | US
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Telephone | 818-669-4526
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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. CHRISTINE POURANDRIAS
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Credential | PSY.D.
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Telephone | 818-669-4526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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