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NPI Code Detail

MEDICARE: DR. GARRETT RICHARD HORNE PSY.D.

MEDICARE: DR. GARRETT RICHARD HORNE 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 PsychologistPSY 19497CA

General Provider Information

NPI Number : 1194806414
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GARRETT RICHARD HORNE PSY.D.
Provider Business Mailing Address
First Line : 550 S VERMONT AVE
Second Line : EOB/PMRT SA 3 10TH FLOOR
City : LOS ANGELES
State : CA
Zip : 90020-1912
Country : US
Telephone Number : 626-258-2004
Fax Number : 626-455-0623
Provider Business Practice Location Address
First Line : 1359 N GRAND AVE
Second Line :
City : COVINA
State : CA
Zip : 91724-1016
Country : US
Telephone Number : 626-430-2901
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2006
Last Update Date : 03/18/2021

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