| Pro Psych Services Inc | |
|
12501 Chandler Blvd Ste 102 Valley Village CA 91607-1955 | |
| (818) 821-6012 | |
| (818) 821-6014 |
| Full Name | Pro Psych Services Inc |
|---|---|
| Speciality | Psychologist |
| Location | 12501 Chandler Blvd Ste 102, Valley Village, California |
| Authorized Official Name and Position | Ronald Louis Kaufman (CEO) |
| Authorized Official Contact | 8188216012 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pro Psych Services Inc 12501 Chandler Blvd Ste 102 Valley Village CA 91607-1955 Ph: (818) 821-6012 | Pro Psych Services Inc 12501 Chandler Blvd Ste 102 Valley Village CA 91607-1955 Ph: (818) 821-6012 |
| NPI Number | 1043224959 |
|---|---|
| Provider Enumeration Date | 07/28/2006 |
| Last Update Date | 04/30/2019 |
| Medicare PECOS PAC ID | 2264329119 |
|---|---|
| Medicare Enrollment ID | O20040303001336 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043224959 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Ronald L Kaufman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558372136 PECOS PAC ID: 3870480726 Enrollment ID: I20040305000607 |
| Provider Name | John A Ayvazian |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922052380 PECOS PAC ID: 4082626023 Enrollment ID: I20060612000306 |
| Provider Name | Murray J Weiss |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811188519 PECOS PAC ID: 0840478574 Enrollment ID: I20110629000275 |
| Provider Name | Roberto J Vado |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740601228 PECOS PAC ID: 9739481490 Enrollment ID: I20160112002226 |
| Provider Name | Daniel T Mckinney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518325729 PECOS PAC ID: 4789980160 Enrollment ID: I20160310001747 |
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