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NPI Code Detail

MEDICARE: DR. JENNIFER CALLAHAN PSY.D

MEDICARE:  DR. JENNIFER  CALLAHAN  PSY.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPSY25258CA

General Provider Information

NPI Number : 1013354166
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER CALLAHAN PSY.D
Provider Business Mailing Address
First Line : 3835 E THOUSAND OAKS BLVD # 364
Second Line :
City : WESTLAKE VILLAGE
State : CA
Zip : 91362-3637
Country : US
Telephone Number : 818-583-6221
Fax Number :
Provider Business Practice Location Address
First Line : 3835 E THOUSAND OAKS BLVD # 364
Second Line :
City : WESTLAKE VILLAGE
State : CA
Zip : 91362-3637
Country : US
Telephone Number : 818-583-6221
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2013
Last Update Date : 11/12/2022

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