Organization
BOULEVARD THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE WALKER PSY.D. (CLINICAL PSYCHOLOGIST/OWNER)
(818) 512-8164
Entity
Organization
Contact information
Practice address
12456 VENTURA BLVD STE 1, STUDIO CITY, CA 91604-2484
(818) 512-8164
Mailing address
12456 VENTURA BLVD STE 1, STUDIO CITY, CA 91604-2484
(818) 512-8164
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY16783
CA
Other
Enumeration date
08/09/2017
Last updated
07/21/2022
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