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Organization
JAIME ELIZABETH MEDVENE PHD A PROFESSIONAL PSYCHOLOGICAL CORPORA
Active
Organization
JAIME ELIZABETH MEDVENE PHD A PROFESSIONAL PSYCHOLOGICAL CORPORA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAIME ELIZABETH MEDVENE PHD (PRESIDENT)
(818) 981-7845
Entity
Organization
Contact information
Practice address
30200 AGOURA RD, SUITE 190, AGOURA HILLS, CA 91301-5434
(818) 981-7845
Mailing address
30200 AGOURA RD, SUITE 190, AGOURA HILLS, CA 91301-5434
(818) 981-7845
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
CP13740
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PSY137401
—
CA
Enumeration date
01/30/2009
Last updated
05/15/2020
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