| Human Development Associates Clinical & Forensic Psychology Inc. | |
|
7250 Franklin Ave Unit 1115 Los Angeles CA 90046-3046 | |
| (323) 874-6966 | |
| (323) 874-1419 |
| Full Name | Human Development Associates Clinical & Forensic Psychology Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 7250 Franklin Ave, Los Angeles, California |
| Authorized Official Name and Position | Joseph Henry Pruitt (PROVIDER) |
| Authorized Official Contact | 3238746966 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Human Development Associates Clinical & Forensic Psychology Inc. 7250 Franklin Ave Unit 1115 Los Angeles CA 90046-3046 Ph: (323) 874-6966 | Human Development Associates Clinical & Forensic Psychology Inc. 7250 Franklin Ave Unit 1115 Los Angeles CA 90046-3046 Ph: (323) 874-6966 |
| NPI Number | 1306155973 |
|---|---|
| Provider Enumeration Date | 09/30/2010 |
| Last Update Date | 01/31/2011 |
| Medicare PECOS PAC ID | 1254524762 |
|---|---|
| Medicare Enrollment ID | O20101015001190 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306155973 | NPI | - | NPPES |
| 00PL40890 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY4089 (California) | Primary |
| Provider Name | Joseph H Pruitt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609957158 PECOS PAC ID: 5698968105 Enrollment ID: I20101101001247 |
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