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NPI Code Detail

MEDICARE: BERKELEY PSYCHOLOGICAL SERVICES

MEDICARE: BERKELEY PSYCHOLOGICAL SERVICES
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
1103TB0200XCognitive & Behavioral PsychologistRP 000077CA

General Provider Information

NPI Number : 1134284128
Entity Type Code : Organization
Provider Name (Legal Business Name) : BERKELEY PSYCHOLOGICAL SERVICES
Provider Business Mailing Address
First Line : 101 S KRAEMER BLVD STE 125
Second Line :
City : PLACENTIA
State : CA
Zip : 92870-6100
Country : US
Telephone Number : 714-524-0201
Fax Number : 714-524-0202
Provider Business Practice Location Address
First Line : 101 S KRAEMER BLVD
Second Line : SUITE 125
City : PLACENTIA
State : CA
Zip : 92870-6105
Country : US
Telephone Number : 714-524-0201
Fax Number : 714-524-0202
Authorized Official
Title or Position : DIRECTOR
Name : DR. JUDITH ANN LINNAN
Credential : PHD PSYCHOANALYST
Telephone Number : 714-524-0201
Provider Enumeration Date : 12/27/2006
Last Update Date : 08/22/2020

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Directions to “BERKELEY PSYCHOLOGICAL SERVICES ” Practice Location

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