Provider Demographics
NPI:1083922884
Name:PACIFIC PSYCHOLOGY, INC
Entity Type:Organization
Organization Name:PACIFIC PSYCHOLOGY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/SUPERVISING PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:Q
Authorized Official - Last Name:MOODY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:818-425-4411
Mailing Address - Street 1:23801 CALABASAS RD STE 2036
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-3462
Mailing Address - Country:US
Mailing Address - Phone:818-425-4411
Mailing Address - Fax:
Practice Address - Street 1:23801 CALABASAS RD STE 2036
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-3462
Practice Address - Country:US
Practice Address - Phone:818-425-4411
Practice Address - Fax:844-228-0533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-15
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty