Basic Information
| Provider Information | |||||||||
| NPI: | 1629301676 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RICHARD OELBERGER, PHD PSYCHOLOGICAL SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 292 S LA CIENEGA BLVD | ||||||||
| Address2: | SUITE 400/ PHC | ||||||||
| City: | BEVERLY HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902113330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104906733 | ||||||||
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| Practice Location | |||||||||
| Address1: | 292 S LA CIENEGA BLVD | ||||||||
| Address2: | SUITE 400/ PHC | ||||||||
| City: | BEVERLY HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902113330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104906733 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2009 | ||||||||
| LastUpdateDate: | 09/09/2009 | ||||||||
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| AuthorizedOfficialLastName: | OELBERGER | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
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| AuthorizedOfficialTitleorPosition: | PSYCHOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 3104906733 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PHD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | PSY 22186 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.