Provider Demographics
NPI:1578148938
Name:PJ THERAPY SERVICES INC.
Entity Type:Organization
Organization Name:PJ THERAPY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:K
Authorized Official - Last Name:GERHARD - JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:714-865-8158
Mailing Address - Street 1:4954 BILOXI AVE
Mailing Address - Street 2:
Mailing Address - City:N HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-4813
Mailing Address - Country:US
Mailing Address - Phone:714-865-8158
Mailing Address - Fax:
Practice Address - Street 1:3808 W RIVERSIDE DR STE 500
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-5301
Practice Address - Country:US
Practice Address - Phone:714-865-8158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)