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Organization

VICTORIA A MENCHACA PHD A PSYCHOLOGICAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. VICTORIA ANN MENCHACA PH.D. (PRESIDENT)
(323) 938-0748
Entity
Organization

Contact information

Practice address
265 S. WESTERN AVE, SUITE 741808, LOS ANGELES, CA 90004-8808
(323) 938-0748
Mailing address
PO BOX 741808, LOS ANGELES, CA 90004-8808
(323) 938-0748

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
PSY10969
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PSY10969
CA PSYCHOLOGY LICENSURE
CA
05
PSY109690
CA
Enumeration date
02/03/2009
Last updated
01/08/2015
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