MEDICARE: HG PSYCHOLOGY, PC

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	103G00000X	Clinical Neuropsychologist

General Provider Information

NPI Number	:	1396576583
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HG PSYCHOLOGY, PC

Provider Business Mailing Address
First Line	:	324 S BEVERLY DR # 901
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-4822
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9356 1/2 W OLYMPIC BLVD
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-4539
Country	:	US
Telephone Number	:	818-292-4803
Fax Number	:

Authorized Official
Title or Position	:	NEUROPSYCHOLOGIST
Name	:	DR. HOLLY GEORGE
Credential	:	PSYD
Telephone Number	:	818-292-4803

Provider Enumeration Date	:	08/09/2024
Last Update Date	:	08/09/2024

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