Provider Demographics
NPI:1568752509
Name:K&A PSYCHOLOGICAL SERVICES INC
Entity Type:Organization
Organization Name:K&A PSYCHOLOGICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:REZA
Authorized Official - Last Name:RIAHINEJAD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-387-4119
Mailing Address - Street 1:1302 AVENIDA DE CORTEZ
Mailing Address - Street 2:1302 AVENIDA DE CORTEZ
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-2123
Mailing Address - Country:US
Mailing Address - Phone:310-387-4119
Mailing Address - Fax:
Practice Address - Street 1:1302 AVENIDA DE CORTEZ
Practice Address - Street 2:1302 AVENIDA DE CORTEZ
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-2123
Practice Address - Country:US
Practice Address - Phone:310-387-4119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-11
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16858261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health