Provider Demographics
NPI:1295214054
Name:PHITT SERVICES
Entity Type:Organization
Organization Name:PHITT SERVICES
Other - Org Name:PSYCHOLOGICAL HEALTH, INTERVENTITIONS, TESTING AND THERAPY SERVICES, I
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RHYAN
Authorized Official - Middle Name:N
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:323-418-2978
Mailing Address - Street 1:6320 CANOGA AVE STE 1500
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-2517
Mailing Address - Country:US
Mailing Address - Phone:323-418-2978
Mailing Address - Fax:
Practice Address - Street 1:6320 CANOGA AVE STE 1500
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-2517
Practice Address - Country:US
Practice Address - Phone:323-418-2978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-11
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY30106103TB0200X, 103TC0700X, 103TF0000X, 103TF0200X, 103TM1800X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Multi-Specialty
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Multi-Specialty
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty