Provider Demographics
NPI:1437708955
Name:TSOLINE KONIALIAN PSYCHOLOGICAL SERVICES, INC.
Entity Type:Organization
Organization Name:TSOLINE KONIALIAN PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:ANGARELLA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:626-586-1220
Mailing Address - Street 1:PO BOX 2521
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91017-2521
Mailing Address - Country:US
Mailing Address - Phone:626-586-1220
Mailing Address - Fax:626-359-6535
Practice Address - Street 1:482 N ROSEMEAD BLVD STE 207
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3053
Practice Address - Country:US
Practice Address - Phone:626-586-1220
Practice Address - Fax:626-359-6535
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TSOLINE KONIALIAN PSYCHOLOGICAL SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty