Organization
NEUROPSYCHOLOGYCA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXANDREA PARK PSY.D. (EXECUTIVE)
(424) 245-5524
Entity
Organization
Contact information
Practice address
9663 SANTA MONICA BLVD # 1058, BEVERLY HILLS, CA 90210-4303
(424) 245-5524
Mailing address
9663 SANTA MONICA BLVD # 1058, BEVERLY HILLS, CA 90210-4303
(424) 245-5524
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
25773
CA
103TH0004X
Health Psychologist
25773
CA
Other
Enumeration date
07/11/2013
Last updated
01/23/2024
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