Provider Demographics
NPI:1427621234
Name:CALIFORNIA HEALTH PSYCHOLOGY PC
Entity type:Organization
Organization Name:CALIFORNIA HEALTH PSYCHOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIBANI
Authorized Official - Middle Name:
Authorized Official - Last Name:RAY-MAZUMDER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:631-786-9312
Mailing Address - Street 1:607 FOOTHILL BOULEVARD, #754
Mailing Address - Street 2:LA CANADA
Mailing Address - City:FLINTRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91011-3402
Mailing Address - Country:US
Mailing Address - Phone:646-820-9652
Mailing Address - Fax:
Practice Address - Street 1:3628 GIDDINGS RANCH RD
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001-3827
Practice Address - Country:US
Practice Address - Phone:631-786-9312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health