| Dynamic Psychotherapy Center Inc | |
|
24520 Hawthorne Blvd Ste 208 Torrance CA 90505-6843 | |
| (562) 584-7715 | |
| Not Available |
| Full Name | Dynamic Psychotherapy Center Inc |
|---|---|
| Speciality | Psychologist |
| Location | 24520 Hawthorne Blvd Ste 208, Torrance, California |
| Authorized Official Name and Position | Valeria M Krocak (OWNER) |
| Authorized Official Contact | 5625847715 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynamic Psychotherapy Center Inc 24520 Hawthorne Blvd Ste 208 Torrance CA 90505-6843 Ph: (562) 584-7715 | Dynamic Psychotherapy Center Inc 24520 Hawthorne Blvd Ste 208 Torrance CA 90505-6843 Ph: (562) 584-7715 |
| NPI Number | 1811651797 |
|---|---|
| Provider Enumeration Date | 10/26/2021 |
| Last Update Date | 10/26/2021 |
| Certification Date | 10/26/2021 |
| Medicare PECOS PAC ID | 0547652505 |
|---|---|
| Medicare Enrollment ID | O20220125000724 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811651797 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Valeria Krocak |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649619180 PECOS PAC ID: 8022330083 Enrollment ID: I20141202000000 |
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