Provider Demographics
NPI:1215577523
Name:HARBOR PSYCHOLOGIST, INC.
Entity type:Organization
Organization Name:HARBOR PSYCHOLOGIST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZECHARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:OREN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-808-4510
Mailing Address - Street 1:4325 GLENCOE AVE # 9651
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-9991
Mailing Address - Country:US
Mailing Address - Phone:310-808-4510
Mailing Address - Fax:
Practice Address - Street 1:1137 2ND ST STE 201
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5086
Practice Address - Country:US
Practice Address - Phone:310-808-4510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-14
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty