Provider Demographics
NPI:1629301676
Name:RICHARD OELBERGER, PHD PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:RICHARD OELBERGER, PHD PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:OELBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-490-6733
Mailing Address - Street 1:292 S LA CIENEGA BLVD
Mailing Address - Street 2:SUITE 400/ PHC
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3330
Mailing Address - Country:US
Mailing Address - Phone:310-490-6733
Mailing Address - Fax:
Practice Address - Street 1:292 S LA CIENEGA BLVD
Practice Address - Street 2:SUITE 400/ PHC
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3330
Practice Address - Country:US
Practice Address - Phone:310-490-6733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 22186103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty