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Organization
PETRUS PSYCHOLOGY PROFESSIONAL CORPORATION
Active
Organization
PETRUS PSYCHOLOGY PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GINA PETRUS PHD (SECRETARY)
(805) 496-6180
Entity
Organization
Contact information
Practice address
3625 E THOUSAND OAKS BLVD, SUITE 135, WESTLAKE VILLAGE, CA 91362-3626
(805) 496-6180
Mailing address
3625 E THOUSAND OAKS BLVD, SUITE 135, WESTLAKE VILLAGE, CA 91362-3626
(805) 496-6180
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY17390
CA
103TC0700X
Clinical Psychologist
PSY19903
CA
Other
Enumeration date
05/23/2007
Last updated
09/18/2007
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