Provider Demographics
NPI:1457809758
Name:CALIFORNIA THERAPY CENTER & PSYCHOLOGICAL SERVICES INC
Entity type:Organization
Organization Name:CALIFORNIA THERAPY CENTER & PSYCHOLOGICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/ CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHANJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:818-396-5343
Mailing Address - Street 1:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:LA CANADA FLINTRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91012-0250
Mailing Address - Country:US
Mailing Address - Phone:818-396-5343
Mailing Address - Fax:818-561-3997
Practice Address - Street 1:595 E COLORADO BLVD STE 205
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2028
Practice Address - Country:US
Practice Address - Phone:818-396-5343
Practice Address - Fax:818-561-3997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
CAPSY19694103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00CP196940Medicaid
CACP19694Medicare PIN