Provider Demographics
NPI:1952130569
Name:EDITH A COOKE PSYD PSYCHOLOGIST INC
Entity type:Organization
Organization Name:EDITH A COOKE PSYD PSYCHOLOGIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:COOKE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:310-497-1404
Mailing Address - Street 1:21833 WOODLAND CREST DR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-5252
Mailing Address - Country:US
Mailing Address - Phone:310-497-1404
Mailing Address - Fax:
Practice Address - Street 1:5016 PARKWAY CALABASAS STE 212
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-3900
Practice Address - Country:US
Practice Address - Phone:310-497-1404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty