Provider Demographics
NPI:1912305178
Name:PSYCHOTHERAPY & PSYCHOEDUCATIONAL ASSESSMENTS
Entity Type:Organization
Organization Name:PSYCHOTHERAPY & PSYCHOEDUCATIONAL ASSESSMENTS
Other - Org Name:PSYCHOTHERAPY & PSYCHOEDUCATIONAL ASSESSMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-779-8455
Mailing Address - Street 1:3108 GLENDALE BLVD # 560
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-1806
Mailing Address - Country:US
Mailing Address - Phone:310-779-8455
Mailing Address - Fax:
Practice Address - Street 1:3108 GLENDALE BLVD # 560
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-1806
Practice Address - Country:US
Practice Address - Phone:310-779-8455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-19
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY26488103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty