Provider Demographics
NPI:1639515521
Name:ROBERT BRIONES, A PSYCHOLOGICAL CORPORATION
Entity Type:Organization
Organization Name:ROBERT BRIONES, A PSYCHOLOGICAL CORPORATION
Other - Org Name:UNIVERSITY PARK PSYCHOLOGICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:R
Authorized Official - Last Name:BRIONES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:818-636-1215
Mailing Address - Street 1:3982 S FIGUEROA ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037-1215
Mailing Address - Country:US
Mailing Address - Phone:213-747-4707
Mailing Address - Fax:
Practice Address - Street 1:3982 S FIGUEROA ST
Practice Address - Street 2:SUITE 203
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037-1215
Practice Address - Country:US
Practice Address - Phone:213-747-4707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-17
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15198103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty