BLAIR WELLNESS GROUP A PROFESSIONAL PSYCHOLOGICAL CORP (NPI# 1962941450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962941450 |
| Entity Type | Organization |
| Organization Name | BLAIR WELLNESS GROUP A PROFESSIONAL PSYCHOLOGICAL CORP |
| Practice Address |
9454 Wilshire Blvd Ph6 Beverly Hills CA 90212-2937 |
| Mailing Address |
12021 Wilshire Blvd # 430 Los Angeles CA 90025-1206 |
| Practice Telephone | 3108666414 |
| Mailing Telephone | 3108666414 |
| Enumeration Date | 2017-02-16 |
| Last Update Date | 2017-03-03 |
| Authorized Official Name | CASSIBY F BLAIR (OWNER) |
| Authorized Official Telephone | 3108666414 |
| Authorized Official Credential | PSYD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Street Address |
9454 WILSHIRE BLVD PH6 |
| City | BEVERLY HILLS |
| State | CA |
| Zip Code | 90212-2937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629535604 | Diego Bautista | Specialist/Technologist, Other | 324 S Beverly Drive #214, Beverely Hills, CA 90212 | 2019-02-26 |
| 1124582978 | California Surgery of Excellence, LLC | Clinic/Center | 269 S Beverly Dr Ste 809, Beverly Hills, CA 90212 | 2019-01-25 |
| 1356818132 | Kari Michelle Sacks | Social Worker | 300 South Beverly Drive, Beverly Hills, CA 90212 | 2018-10-30 |
| 1942782370 | Susan Elizabeth Smiley | Technician, Other | 160 S. Lasky Drive, Beverly Hills, CA 90212 | 2018-09-01 |
| 1417443714 | Sharona Asal Mossazadeh | Physician Assistant | 344 S Rodeo Dr, Beverly Hills, CA 90212 | 2018-07-10 |
| 1760983167 | Nina Rebecca Moradi | Marriage & Family Therapist | 420 S. Beverly Dr., Suite 100-19, Beverly Hills, CA 90212 | 2018-02-22 |
| 1376065946 | Rebecca Shelly Agi | Lactation Consultant, Non-RN | 350 South Reeves Dr., 201, Beverly Hills, CA 90212 | 2017-07-14 |
| 1952853582 | Dmarkis Randolph | Dietetic Technician, Registered | 269 S Beverly Drive, 1038, Beverly Hills, CA 90212 | 2016-10-31 |
| 1023560935 | Barrence Baytos | Kinesiotherapist | 260 S. Beverly Drive, Suite # 210, Beverly Hills, CA 90212 | 2016-10-26 |
| 1467810424 | Laura Fischer | Registered Nurse | 120 S Spalding Dr Ste 301, Beverly Hills, CA 90212 | 2016-02-05 |
| Find all providers in zip 90212 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386266021 | Reconnect Relationship, A Professional Psychology Corporation | Psychologist | 499 N Canon Dr Ste 216, Beverly Hills, CA 90210-4887 | 2020-05-15 |
| 1366073975 | Monica S. Wu | Psychologist | 9454 Wilshire Blvd Ph 1025, Beverly Hills, CA 90212-2937 | 2020-02-01 |
| 1215588983 | Dana Tal Jebreel | Psychologist | 450 N Bedford Dr Ste 204, Beverly Hills, CA 90210-4306 | 2019-09-24 |
| 1427610831 | Rebecca Lesser Allen | Psychologist | 451 N Canon Dr, Beverly Hills, CA 90210-4890 | 2019-07-05 |
| 1760972467 | Francisco Javier Iribarren | Psychologist | 8383 Wilshire Blvd Ste 800, Beverly Hills, CA 90211 | 2018-05-17 |
| 1366931339 | Dr. C Shoham Psychological Services | Psychologist | 9454 Wilshire Blvd Ste 24, Beverly Hills, CA 90212-2931 | 2018-05-05 |
| 1134636764 | Catherine Renee Selden | Psychologist | 433 N Camden Dr Fl 4, Beverly Hills, CA 90210-4408 | 2018-01-04 |
| 1306398342 | Jill Model Barth | Psychologist | 249 S Rodeo Dr, Suite A, Beverly Hills, CA 90212-3803 | 2016-10-25 |
| 1285094508 | David E. Kronemyer | Psychologist | 9812 Gloucester Dr, Beverly Hills, CA 90210-1015 | 2016-02-29 |
| 1063870764 | Michael J. Whitman, A Psychological Corporation | Psychologist | 360 N Bedford Dr Ste 319, Beverly Hills, CA 90210-5121 | 2016-02-09 |
| Find all providers in BEVERLY HILLS | ||||
| City | BEVERLY HILLS |
| Zip Code | 90212 |
Please comment or provide details below to improve the information on BLAIR WELLNESS GROUP A PROFESSIONAL PSYCHOLOGICAL CORP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.