Provider Demographics
NPI:1730633702
Name:PSYCHOLOGICAL HEALING CENTER
Entity type:Organization
Organization Name:PSYCHOLOGICAL HEALING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-739-4491
Mailing Address - Street 1:15615 CASTLEWOODS DR
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-4806
Mailing Address - Country:US
Mailing Address - Phone:310-739-4491
Mailing Address - Fax:
Practice Address - Street 1:15615 CASTLEWOODS DR
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-4806
Practice Address - Country:US
Practice Address - Phone:310-739-4491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty