Provider Demographics
NPI:1407182413
Name:CALIFORNIA PSYCHOLOGICAL RESOURCES, INC.
Entity Type:Organization
Organization Name:CALIFORNIA PSYCHOLOGICAL RESOURCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCTAGUE-LOFT
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MFT
Authorized Official - Phone:805-241-6700
Mailing Address - Street 1:5655 LINDERO CANYON RD
Mailing Address - Street 2:SUITE 621
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-4016
Mailing Address - Country:US
Mailing Address - Phone:805-241-6700
Mailing Address - Fax:
Practice Address - Street 1:5655 LINDERO CANYON RD
Practice Address - Street 2:SUITE 621
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-4016
Practice Address - Country:US
Practice Address - Phone:805-241-6700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47763106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty