Basic Information
| Provider Information | |||||||||
| NPI: | 1235551169 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STEVEN DAVID PH.D. & ASSOCIATES, A PROFESSIONAL PSYCHOLOGY CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11022 SANTA MONICA BLVD STE 270 | ||||||||
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| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900257566 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3234010493 | ||||||||
| FaxNumber: | 3102731818 | ||||||||
| Practice Location | |||||||||
| Address1: | 11022 SANTA MONICA BLVD STE 270 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900257566 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3234010493 | ||||||||
| FaxNumber: | 3102731818 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2014 | ||||||||
| LastUpdateDate: | 03/15/2019 | ||||||||
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| AuthorizedOfficialLastName: | DAVID | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 3234010493 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PH.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | PSY22018 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.