| Agoura Psychological Services, Inc. | |
|
5014 Chesebro Rd Second Floor Agoura Hills CA 91301-2278 | |
| (888) 691-3223 | |
| Not Available |
| Full Name | Agoura Psychological Services, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 5014 Chesebro Rd, Agoura Hills, California |
| Authorized Official Name and Position | Ajay Malhotra (OWNER) |
| Authorized Official Contact | 8886913223 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agoura Psychological Services, Inc. 5014 Chesebro Rd Second Floor Agoura Hills CA 91301-2278 Ph: (888) 691-3223 | Agoura Psychological Services, Inc. 5014 Chesebro Rd Second Floor Agoura Hills CA 91301-2278 Ph: (888) 691-3223 |
| NPI Number | 1144646423 |
|---|---|
| Provider Enumeration Date | 03/11/2014 |
| Last Update Date | 03/11/2014 |
| Medicare PECOS PAC ID | 1557584919 |
|---|---|
| Medicare Enrollment ID | O20140603002467 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144646423 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY12365 (California) | Primary |
| Provider Name | Ajay K Malhotra |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710206420 PECOS PAC ID: 3678756913 Enrollment ID: I20110324000540 |
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