| Boulevard Therapy | |
|
12456 Ventura Blvd Ste 1 Studio City CA 91604-2484 | |
| (818) 512-8164 | |
| Not Available |
| Full Name | Boulevard Therapy |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 12456 Ventura Blvd Ste 1, Studio City, California |
| Authorized Official Name and Position | Nicole Walker (CLINICAL PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 8185128164 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boulevard Therapy 12456 Ventura Blvd Ste 1 Studio City CA 91604-2484 Ph: (818) 512-8164 | Boulevard Therapy 12456 Ventura Blvd Ste 1 Studio City CA 91604-2484 Ph: (818) 512-8164 |
| NPI Number | 1114442241 |
|---|---|
| Provider Enumeration Date | 08/09/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114442241 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY16783 (California) | Primary |
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