Provider Demographics
NPI:1639477664
Name:PSLA
Entity Type:Organization
Organization Name:PSLA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:PARISI
Authorized Official - Suffix:JR
Authorized Official - Credentials:MFT
Authorized Official - Phone:310-424-8516
Mailing Address - Street 1:9300 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3213
Mailing Address - Country:US
Mailing Address - Phone:310-424-8516
Mailing Address - Fax:310-276-4010
Practice Address - Street 1:9300 WILSHIRE BLVD
Practice Address - Street 2:SUITE 306
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3213
Practice Address - Country:US
Practice Address - Phone:310-424-8516
Practice Address - Fax:310-276-4010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 44338106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty