Provider Demographics
NPI:1457989436
Name:JS STIMSON PSYCHOLOGICAL CORPORATION
Entity Type:Organization
Organization Name:JS STIMSON PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:S
Authorized Official - Last Name:STIMSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:310-387-2114
Mailing Address - Street 1:1384 WESLEY AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-2639
Mailing Address - Country:US
Mailing Address - Phone:310-387-2114
Mailing Address - Fax:
Practice Address - Street 1:12304 SANTA MONICA BLVD STE 215A
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-2587
Practice Address - Country:US
Practice Address - Phone:310-387-2114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty