MEDICARE: DR. MARIA MOLA PARENT PH.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
1	103TC0700X	Clinical Psychologist	PSY11069	CA

General Provider Information

NPI Number	:	1013929512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA MOLA PARENT PH.D

Provider Business Mailing Address
First Line	:	3786 LA CRESCENTA AVE STE 101
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91208-1059
Country	:	US
Telephone Number	:	818-541-9276
Fax Number	:	818-241-5785

Provider Business Practice Location Address
First Line	:	3786 LA CRESCENTA AVE STE 101
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91208-1546
Country	:	US
Telephone Number	:	818-541-9276
Fax Number	:	818-241-5785

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	07/21/2022

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