Basic Information
| Provider Information | |||||||||
| NPI: | 1427181528 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PANSTER | ||||||||
| FirstName: | PETRA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 21380 CENTRE POINTE PKWY | ||||||||
| Address2: | |||||||||
| City: | SANTA CLARITA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913503050 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6613831805 | ||||||||
| FaxNumber: | 6612548653 | ||||||||
| Practice Location | |||||||||
| Address1: | 21380 CENTRE POINTE PKWY | ||||||||
| Address2: | |||||||||
| City: | SANTA CLARITA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6612862550 | ||||||||
| FaxNumber: | 6612862567 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2007 | ||||||||
| LastUpdateDate: | 07/12/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | PSY21100 | CA | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.