Provider Demographics
NPI:1689978082
Name:ROBERT S TASOFF PH D A PSYCHOLOGY CORPORATION
Entity Type:Organization
Organization Name:ROBERT S TASOFF PH D A PSYCHOLOGY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:STEWART
Authorized Official - Last Name:TASOFF
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:818-567-2015
Mailing Address - Street 1:213 W ALAMEDA AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-2571
Mailing Address - Country:US
Mailing Address - Phone:818-567-2015
Mailing Address - Fax:818-567-2015
Practice Address - Street 1:213 W ALAMEDA AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-2571
Practice Address - Country:US
Practice Address - Phone:818-567-2015
Practice Address - Fax:818-567-2015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-29
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty