Provider Demographics
NPI:1710216684
Name:ACCARDI, JUDITH R (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:R
Last Name:ACCARDI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3231 OCEAN PARK BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-3221
Mailing Address - Country:US
Mailing Address - Phone:310-396-2037
Mailing Address - Fax:
Practice Address - Street 1:3231 OCEAN PARK BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-3221
Practice Address - Country:US
Practice Address - Phone:310-396-2037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-23
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 21646103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist