Provider Demographics
NPI:1013494384
Name:TEST FOR SUCCESS PSYCHOLOGY, INC.
Entity Type:Organization
Organization Name:TEST FOR SUCCESS PSYCHOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDRIA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:GLASSER DAS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:850-850-3794
Mailing Address - Street 1:23501 PARK SORRENTO STE 101
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1369
Mailing Address - Country:US
Mailing Address - Phone:310-488-5127
Mailing Address - Fax:
Practice Address - Street 1:23501 PARK SORRENTO STE 101
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1369
Practice Address - Country:US
Practice Address - Phone:805-850-3794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty