Provider Demographics
NPI:1871867614
Name:THOMAS C. OLONA, PSYCHOLOGIST, PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:THOMAS C. OLONA, PSYCHOLOGIST, PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:OLONA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:818-476-0117
Mailing Address - Street 1:100 N BRAND BLVD
Mailing Address - Street 2:SUITE 603
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-2641
Mailing Address - Country:US
Mailing Address - Phone:818-476-1007
Mailing Address - Fax:
Practice Address - Street 1:100 N BRAND BLVD
Practice Address - Street 2:SUITE 603
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-2641
Practice Address - Country:US
Practice Address - Phone:818-476-1007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-25
Last Update Date:2017-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14944103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty