Organization
COUNSELING CENTER OF SANTA MONICA - A PSYCHOLOGICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REUBEN VAISMAN-TZACHOR PH.D. (PRESIDENT - OWNER)
(310) 477-6000
Entity
Organization
Contact information
Practice address
1321 9TH ST, SANTA MONICA, CA 90401-1803
(310) 477-6000
(310) 477-0327
Mailing address
1321 9TH ST, SANTA MONICA, CA 90401-1803
(310) 477-6000
(310) 477-0327
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PSY 15091
CA
103T00000X
Psychologist
Primary
PSY 15091
CA
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PSY 15091
CA
103TA0700X
Adult Development & Aging Psychologist
PSY 15091
CA
103TB0200X
Cognitive & Behavioral Psychologist
PSY 15091
CA
103TC0700X
Clinical Psychologist
PSY 15091
CA
103TC1900X
Counseling Psychologist
PSY 15091
CA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY 15091
CA
103TE1100X
Exercise & Sports Psychologist
PSY 15091
CA
103TF0000X
Family Psychologist
PSY 15091
CA
103TF0200X
Forensic Psychologist
PSY 15091
CA
103TP2701X
Group Psychotherapy Psychologist
PSY 15091
CA
Other
Enumeration date
12/21/2006
Last updated
12/10/2008
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