Provider Demographics
NPI:1316493737
Name:ALBECZ, ASA MARIA (REEGT RPSGT)
Entity type:Individual
Prefix:
First Name:ASA
Middle Name:MARIA
Last Name:ALBECZ
Suffix:
Gender:F
Credentials:REEGT RPSGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15021 VENTURA BLVD # 393
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2442
Mailing Address - Country:US
Mailing Address - Phone:818-442-8350
Mailing Address - Fax:
Practice Address - Street 1:630 S RAYMOND AVE
Practice Address - Street 2:#310
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3278
Practice Address - Country:US
Practice Address - Phone:818-442-8350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47132472E0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEG