Provider Demographics
NPI:1780334474
Name:BALESTRIERI PSYCHOLOGY SERVICES, PA
Entity type:Organization
Organization Name:BALESTRIERI PSYCHOLOGY SERVICES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BALESTRIERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-993-1664
Mailing Address - Street 1:9903 SANTA MONICA BLVD STE 823
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-1671
Mailing Address - Country:US
Mailing Address - Phone:310-299-2040
Mailing Address - Fax:
Practice Address - Street 1:9152 ALDEN DR
Practice Address - Street 2:UNIT 9
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210
Practice Address - Country:US
Practice Address - Phone:310-299-2040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)