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General NPI Number Information
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NPI Number | 1770863896
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGICAL RESOURCES AND SERVICES, INC
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Dates
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Enumeration Date | 08/19/2011
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Last Update Date | 08/19/2011
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Provider Practice Location Address
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Address Line | 15235 BURBANK BLVD
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City | VAN NUYS
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State | CA
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Zip | 91411-3500
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Country | US
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Telephone | 818-922-7774
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Fax |
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Provider Business Mailing Address
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Address Line | 12400 VENTURA BLVD # 173
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City | STUDIO CITY
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State | CA
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Zip | 91604-2406
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Country | US
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Telephone | 818-922-7774
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. DEANNA FOSTER
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Credential | PH.D.
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Telephone | 818-922-7774
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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 | PSY14284
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License Number State | CA
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