| Dana Grip, Psychologist, Professional Corporation | |
|
2820 Glendale Blvd Ste 4 Los Angeles CA 90039-2723 | |
| (818) 927-1743 | |
| Not Available |
| Full Name | Dana Grip, Psychologist, Professional Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 2820 Glendale Blvd Ste 4, Los Angeles, California |
| Authorized Official Name and Position | Dana Richardson Grip (PRESIDENT) |
| Authorized Official Contact | 8189271743 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dana Grip, Psychologist, Professional Corporation 2820 Glendale Blvd Ste 4 Los Angeles CA 90039-2723 Ph: (818) 927-1743 | Dana Grip, Psychologist, Professional Corporation 2820 Glendale Blvd Ste 4 Los Angeles CA 90039-2723 Ph: (818) 927-1743 |
| NPI Number | 1972014819 |
|---|---|
| Provider Enumeration Date | 10/18/2017 |
| Last Update Date | 05/20/2021 |
| Certification Date | 05/20/2021 |
| Medicare PECOS PAC ID | 2961769948 |
|---|---|
| Medicare Enrollment ID | O20171129001860 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972014819 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY29379 (California) | Primary |
| Provider Name | Dana Richardson Grip |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548693732 PECOS PAC ID: 1951668938 Enrollment ID: I20180115000591 |
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