Provider Demographics
NPI:1396172342
Name:RICK DEATON, PSY.D., A PROF. PSYCH. CORP.
Entity type:Organization
Organization Name:RICK DEATON, PSY.D., A PROF. PSYCH. CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:BAUMAN
Authorized Official - Last Name:DEATON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:213-400-2434
Mailing Address - Street 1:7257 BEVERLY BLVD. , SUITE 116
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036
Mailing Address - Country:US
Mailing Address - Phone:213-400-2434
Mailing Address - Fax:323-966-5939
Practice Address - Street 1:7257 BEVERLY BLVD SUITE 116
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-2567
Practice Address - Country:US
Practice Address - Phone:213-400-2434
Practice Address - Fax:323-966-5939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-07
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty