| Provia Psychology, Inc. | |
|
2530 Atlantic Ave Ste A Long Beach CA 90806-2741 | |
| (949) 500-6475 | |
| Not Available |
| Full Name | Provia Psychology, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 2530 Atlantic Ave Ste A, Long Beach, California |
| Authorized Official Name and Position | Stacia E Deiro (PRESIDENT) |
| Authorized Official Contact | 9495006475 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Provia Psychology, Inc. 2530 Atlantic Ave Ste A Long Beach CA 90806-2741 Ph: (949) 500-6475 | Provia Psychology, Inc. 2530 Atlantic Ave Ste A Long Beach CA 90806-2741 Ph: (949) 500-6475 |
| NPI Number | 1932718350 |
|---|---|
| Provider Enumeration Date | 07/31/2020 |
| Last Update Date | 07/31/2020 |
| Certification Date | 07/31/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932718350 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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