Provider Demographics
NPI:1477806818
Name:JOHN GEIRLAND PH.D. PSYCHOTHERAPY CORPORATION
Entity Type:Organization
Organization Name:JOHN GEIRLAND PH.D. PSYCHOTHERAPY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:GUIDO
Authorized Official - Last Name:GEIRLAND
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:747-333-8148
Mailing Address - Street 1:4335 BECK AVE
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-2806
Mailing Address - Country:US
Mailing Address - Phone:747-333-8148
Mailing Address - Fax:
Practice Address - Street 1:4444 W RIVERSIDE DR STE 305
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4048
Practice Address - Country:US
Practice Address - Phone:747-333-8148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY25197103T00000X, 103TA0700X, 103TB0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Single Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty