| Roxanne Prilutsky, Ph.d., A Psychology Corporation | |
|
630 S Raymond Ave Suite 310 Pasadena CA 91105-3278 | |
| (626) 765-3518 | |
| (626) 765-3532 |
| Full Name | Roxanne Prilutsky, Ph.d., A Psychology Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 630 S Raymond Ave, Pasadena, California |
| Authorized Official Name and Position | Roxanne Prilutsky (PRESIDENT) |
| Authorized Official Contact | 6267653518 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roxanne Prilutsky, Ph.d., A Psychology Corporation 835 E Magnolia Blvd Burbank CA 91501-1311 Ph: (818) 257-4801 | Roxanne Prilutsky, Ph.d., A Psychology Corporation 630 S Raymond Ave Suite 310 Pasadena CA 91105-3278 Ph: (626) 765-3518 |
| NPI Number | 1215365747 |
|---|---|
| Provider Enumeration Date | 10/18/2013 |
| Last Update Date | 11/17/2013 |
| Medicare PECOS PAC ID | 0244463412 |
|---|---|
| Medicare Enrollment ID | O20140424000816 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215365747 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY25879 (California) | Primary |
| Provider Name | Roxanne Prilutsky |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790809499 PECOS PAC ID: 2961635131 Enrollment ID: I20140424000926 |
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