Provider Demographics
NPI:1225465271
Name:JUDD PSYCHOLOGICAL SERVICES INC
Entity Type:Organization
Organization Name:JUDD PSYCHOLOGICAL SERVICES INC
Other - Org Name:EARLY LIFE CHILD PSYCHOLOGY AND EDUCATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:JUDD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:661-312-2875
Mailing Address - Street 1:23822 VALENCIA BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-5348
Mailing Address - Country:US
Mailing Address - Phone:661-437-3287
Mailing Address - Fax:661-244-3513
Practice Address - Street 1:23822 VALENCIA BLVD STE 207
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5348
Practice Address - Country:US
Practice Address - Phone:661-437-3287
Practice Address - Fax:661-244-3513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-07
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY24819251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health