| Family Psychological Services Inc | |
|
30495 Canwood St Ste 101 Agoura Hills CA 91301-4331 | |
| (818) 707-7366 | |
| (818) 306-5836 |
| Full Name | Family Psychological Services Inc |
|---|---|
| Speciality | Psychologist |
| Location | 30495 Canwood St Ste 101, Agoura Hills, California |
| Authorized Official Name and Position | Kim B Barrus, Ph.d. (PRESIDENT) |
| Authorized Official Contact | 8187077366 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Psychological Services Inc 30495 Canwood St Ste 101 Agoura Hills CA 91301-4331 Ph: (818) 707-7366 | Family Psychological Services Inc 30495 Canwood St Ste 101 Agoura Hills CA 91301-4331 Ph: (818) 707-7366 |
| NPI Number | 1881746733 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 04/20/2021 |
| Certification Date | 09/18/2020 |
| Medicare PECOS PAC ID | 6507019379 |
|---|---|
| Medicare Enrollment ID | O20130102000300 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881746733 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY6155 (California) | Primary |
| Provider Name | Kim B Barrus |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871606327 PECOS PAC ID: 7315903028 Enrollment ID: I20041204000172 |
| Provider Name | Kathryn A Fuller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649371022 PECOS PAC ID: 2769567650 Enrollment ID: I20080318000157 |
| Provider Name | Traci V Babcock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790071587 PECOS PAC ID: 9830367416 Enrollment ID: I20110726000672 |
| Provider Name | Marsha L Houston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588775787 PECOS PAC ID: 8729246327 Enrollment ID: I20120229000361 |
| Provider Name | Jennifer Anne Kadin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700076809 PECOS PAC ID: 8921395682 Enrollment ID: I20160922002683 |
| Provider Name | John D Vancamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982156873 PECOS PAC ID: 0345521274 Enrollment ID: I20170106001447 |
| Provider Name | Erin E Holley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346667193 PECOS PAC ID: 1759651326 Enrollment ID: I20170714002109 |
| Provider Name | Cheryl Hodge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548643166 PECOS PAC ID: 4981913191 Enrollment ID: I20170911003169 |
| Provider Name | Michelle Maciel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821292111 PECOS PAC ID: 1557607298 Enrollment ID: I20190116003007 |
| Provider Name | Joan K Dawson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164555488 PECOS PAC ID: 6608865050 Enrollment ID: I20190513000129 |
| Provider Name | Beatrix S Wagner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639358385 PECOS PAC ID: 1850618208 Enrollment ID: I20190531002127 |
| Provider Name | Shabnam M Salanga |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528349321 PECOS PAC ID: 3678801768 Enrollment ID: I20190828000461 |
| Provider Name | Alan D Price |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083754089 PECOS PAC ID: 0840391512 Enrollment ID: I20191112001223 |
| Provider Name | Edmon Psy D Artinyan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578030953 PECOS PAC ID: 5597191502 Enrollment ID: I20200211003020 |
| Provider Name | Audrey Boggs |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932235256 PECOS PAC ID: 6800225103 Enrollment ID: I20200408001917 |
| Provider Name | Bethany Tucker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639387954 PECOS PAC ID: 0042641250 Enrollment ID: I20200502000044 |
| Provider Name | Dzovak Kazandjian |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609329291 PECOS PAC ID: 0345671483 Enrollment ID: I20200505003359 |
| Provider Name | Annemarie Winic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487782959 PECOS PAC ID: 2860811197 Enrollment ID: I20201006000709 |
| Provider Name | Shoni Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467000760 PECOS PAC ID: 2365857273 Enrollment ID: I20210225002968 |
| Provider Name | Stephany Manurung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669065660 PECOS PAC ID: 7012326200 Enrollment ID: I20210428002767 |
| Provider Name | Beth Baumeister |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619256443 PECOS PAC ID: 3971904376 Enrollment ID: I20210623000661 |
| Provider Name | Andrew J Wong |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578997466 PECOS PAC ID: 4082018460 Enrollment ID: I20210806001311 |
| Provider Name | Kim Dannenberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982172201 PECOS PAC ID: 0648668848 Enrollment ID: I20211020001559 |
| Provider Name | Christine Natelli Richard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780310912 PECOS PAC ID: 2769867555 Enrollment ID: I20220914003185 |
| Provider Name | Diana H Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528648284 PECOS PAC ID: 9537536362 Enrollment ID: I20221107002756 |
| Provider Name | Shelley M Showalter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073233664 PECOS PAC ID: 4385000850 Enrollment ID: I20230525002730 |
| Provider Name | Lisa Meneshian |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902011083 PECOS PAC ID: 7911364971 Enrollment ID: I20230606002685 |
| Provider Name | Anthony Odozi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063600732 PECOS PAC ID: 9032563945 Enrollment ID: I20230926004251 |
| Provider Name | Joseph Holifield |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861557571 PECOS PAC ID: 0143674804 Enrollment ID: I20230928002391 |
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