Provider Demographics
NPI:1558751743
Name:EDWARD GIAQUINTO, PH.D., INC
Entity Type:Organization
Organization Name:EDWARD GIAQUINTO, PH.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GIAQUINTO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:818-618-8830
Mailing Address - Street 1:9909 TOPANGA CANYON BLVD
Mailing Address - Street 2:176
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-3602
Mailing Address - Country:US
Mailing Address - Phone:818-618-8830
Mailing Address - Fax:818-713-1116
Practice Address - Street 1:22900 VENTURA BLVD
Practice Address - Street 2:SUITE 125
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1204
Practice Address - Country:US
Practice Address - Phone:818-618-8830
Practice Address - Fax:818-713-1116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 16707103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty