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General NPI Number Information
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NPI Number | 1801089040
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Entity Type | Individual
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Provider Name | HELENA KOPECKY PH.D.
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Gender | Female
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 10/19/2017
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Provider Practice Location Address
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Address Line | 350 S OAKLAND AVE APT. 305
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City | PASADENA
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State | CA
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Zip | 91101-4010
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Country | US
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Telephone | 626-622-3684
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Fax |
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Provider Business Mailing Address
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Address Line | 275 E CALIFORNIA BLVD SUITE J
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City | PASADENA
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State | CA
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Zip | 91106-4747
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Country | US
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Telephone | 626-622-3684
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PSY 20984
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License Number State | CA
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