Provider Demographics
NPI:1285205955
Name:EMPOWERMENT PSYCHOLOGY, A PROFESSIONAL PSYCHOLOGY CORPORATION
Entity Type:Organization
Organization Name:EMPOWERMENT PSYCHOLOGY, A PROFESSIONAL PSYCHOLOGY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-606-8385
Mailing Address - Street 1:2900 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-2046
Mailing Address - Country:US
Mailing Address - Phone:310-801-7399
Mailing Address - Fax:
Practice Address - Street 1:2900 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-2046
Practice Address - Country:US
Practice Address - Phone:310-801-7399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-05
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)