MEDICARE: LESTER SUMMERFIELD AND ASSOCIATES, A PSYCHOLOGICAL CORPORATION

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	103T00000X	Psychologist		CA

General Provider Information

NPI Number	:	1053465799
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LESTER SUMMERFIELD AND ASSOCIATES, A PSYCHOLOGICAL CORPORATION

Provider Business Mailing Address
First Line	:	4045 E THOUSAND OAKS BLVD
Second Line	:	SUITE 220
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91362-3636
Country	:	US
Telephone Number	:	805-496-6992
Fax Number	:	805-496-4787

Provider Business Practice Location Address
First Line	:	4045 E THOUSAND OAKS BLVD
Second Line	:	SUITE 220
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91362-3636
Country	:	US
Telephone Number	:	805-496-6992
Fax Number	:	805-496-4787

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LESTER SUMMERFIELD
Credential	:	PH.D.
Telephone Number	:	805-496-6992

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	08/22/2020

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