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Organization
PACIFIC BLUE PSYCHOLOGICAL SERVICES
Active
Organization
PACIFIC BLUE PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN CARROLL PSYD (OWNER)
(858) 883-3277
Entity
Organization
Contact information
Practice address
15235 BURBANK BLVD STE A2, SHERMAN OAKS, CA 91411-3555
(858) 883-3277
Mailing address
PO BOX 1290, VENICE, CA 90294-1290
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
09/16/2019
Last updated
10/09/2020
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