| Alta-grace L Tan, Psy D Psychological Services, Inc | |
|
18546 Roscoe Blvd Ste 210 Northridge CA 91324-5454 | |
| (818) 886-5628 | |
| Not Available |
| Full Name | Alta-grace L Tan, Psy D Psychological Services, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 18546 Roscoe Blvd, Northridge, California |
| Authorized Official Name and Position | Alta-grace L Tan (OWNER) |
| Authorized Official Contact | 8185231809 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alta-grace L Tan, Psy D Psychological Services, Inc 18546 Roscoe Blvd Ste 210 Northridge CA 91324-5454 Ph: (818) 886-5628 | Alta-grace L Tan, Psy D Psychological Services, Inc 18546 Roscoe Blvd Ste 210 Northridge CA 91324-5454 Ph: (818) 886-5628 |
| NPI Number | 1104920230 |
|---|---|
| Provider Enumeration Date | 09/11/2006 |
| Last Update Date | 05/28/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104920230 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY18653 (California) | Primary |
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