| Dr. Wiyatta Psychology Corporation | |
|
10153 1/2 Riverside Dr Ste 440 Toluca Lake CA 91602-2561 | |
| (310) 621-3673 | |
| Not Available |
| Full Name | Dr. Wiyatta Psychology Corporation |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 10153 1/2 Riverside Dr Ste 440, Toluca Lake, California |
| Authorized Official Name and Position | Wiyatta Fahnbulleh (PSYCHOLOGIST) |
| Authorized Official Contact | 3106213673 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Wiyatta Psychology Corporation 10153 1/2 Riverside Dr Ste 440 Toluca Lake CA 91602-2561 Ph: (310) 621-3673 | Dr. Wiyatta Psychology Corporation 10153 1/2 Riverside Dr Ste 440 Toluca Lake CA 91602-2561 Ph: (310) 621-3673 |
| NPI Number | 1215534565 |
|---|---|
| Provider Enumeration Date | 10/08/2020 |
| Last Update Date | 10/08/2020 |
| Certification Date | 10/01/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215534565 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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