Provider Demographics
NPI:1578332177
Name:HUMAHEALTH PSYCHOLOGY SERVCES
Entity Type:Organization
Organization Name:HUMAHEALTH PSYCHOLOGY SERVCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HUMA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEKCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-954-7940
Mailing Address - Street 1:606 N GALENA AVE
Mailing Address - Street 2:
Mailing Address - City:DIXON
Mailing Address - State:IL
Mailing Address - Zip Code:61021-1620
Mailing Address - Country:US
Mailing Address - Phone:310-954-7940
Mailing Address - Fax:
Practice Address - Street 1:606 N GALENA AVE
Practice Address - Street 2:
Practice Address - City:DIXON
Practice Address - State:IL
Practice Address - Zip Code:61021-1620
Practice Address - Country:US
Practice Address - Phone:310-954-7940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-22
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty