Provider Demographics
NPI:1780397927
Name:SEVEN RAYS PSYCHOLOGY CORP
Entity type:Organization
Organization Name:SEVEN RAYS PSYCHOLOGY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:PIETRZAK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:310-663-7163
Mailing Address - Street 1:21838 ENCINA RD
Mailing Address - Street 2:
Mailing Address - City:TOPANGA
Mailing Address - State:CA
Mailing Address - Zip Code:90290-3527
Mailing Address - Country:US
Mailing Address - Phone:310-663-7163
Mailing Address - Fax:
Practice Address - Street 1:9709 ARTESIA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-8007
Practice Address - Country:US
Practice Address - Phone:310-663-7163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-03
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB240514Medicaid
CAPSY27360OtherSTATE LICENCE