| Kravitz Psychological, Apc | |
|
4766 Park Granada Ste 202 Calabasas CA 91302-3341 | |
| (818) 804-8492 | |
| (310) 756-1225 |
| Full Name | Kravitz Psychological, Apc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 4766 Park Granada Ste 202, Calabasas, California |
| Authorized Official Name and Position | Kim Do (CREDENTIALING MANAGER) |
| Authorized Official Contact | 9092628372 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kravitz Psychological, Apc 22647 Ventura Blvd Ste 851 Woodland Hills CA 91364-1416 Ph: (818) 804-8492 | Kravitz Psychological, Apc 4766 Park Granada Ste 202 Calabasas CA 91302-3341 Ph: (818) 804-8492 |
| NPI Number | 1942988118 |
|---|---|
| Provider Enumeration Date | 07/07/2023 |
| Last Update Date | 10/06/2023 |
| Certification Date | 10/06/2023 |
| Medicare PECOS PAC ID | 0547615965 |
|---|---|
| Medicare Enrollment ID | O20231004003124 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942988118 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| Provider Name | Jena A Kravitz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942463260 PECOS PAC ID: 0446392971 Enrollment ID: I20100122000078 |
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