| Stephanie L. Davidson, Psy.d., A Psychological Corporation | |
|
5743 Corsa Ave Ste 221 Westlake Village CA 91362-6451 | |
| (805) 405-6945 | |
| Not Available |
| Full Name | Stephanie L. Davidson, Psy.d., A Psychological Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 5743 Corsa Ave Ste 221, Westlake Village, California |
| Authorized Official Name and Position | Stephanie Davidson (OWNER) |
| Authorized Official Contact | 8054056945 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephanie L. Davidson, Psy.d., A Psychological Corporation 5743 Corsa Ave Ste 221 Westlake Village CA 91362-6451 Ph: (805) 405-6945 | Stephanie L. Davidson, Psy.d., A Psychological Corporation 5743 Corsa Ave Ste 221 Westlake Village CA 91362-6451 Ph: (805) 405-6945 |
| NPI Number | 1417350430 |
|---|---|
| Provider Enumeration Date | 10/04/2014 |
| Last Update Date | 03/21/2023 |
| Certification Date | 03/21/2023 |
| Medicare PECOS PAC ID | 4880920594 |
|---|---|
| Medicare Enrollment ID | O20190801001176 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417350430 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY24540 (California) | Primary |
| Provider Name | Stephanie Davidson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356535256 PECOS PAC ID: 4082880935 Enrollment ID: I20111227000786 |
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