Provider Demographics
NPI:1215431689
Name:AKZ PSYCHOLOGICAL SERVICES, INC.
Entity type:Organization
Organization Name:AKZ PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:323-897-1018
Mailing Address - Street 1:2213 HYPERION AVENUE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027
Mailing Address - Country:US
Mailing Address - Phone:323-897-1018
Mailing Address - Fax:
Practice Address - Street 1:2213 HYPERION AVENUE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027
Practice Address - Country:US
Practice Address - Phone:323-897-1018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-21
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1902226632Medicaid