Organization
IRENE S. FRUCHTBAUM, PH.D., Q.M.E.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRENE FRUCHTBAUM PH.D., Q.M.E. (CLINICAL PSYCHOLOGIST)
(818) 650-1960
Entity
Organization
Contact information
Practice address
28310 ROADSIDE DR STE 202A, AGOURA HILLS, CA 91301-4958
(818) 650-1960
Mailing address
PO BOX 4117, WEST HILLS, CA 91308-4117
(310) 699-6510
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
—
—
Other
Enumeration date
03/20/2024
Last updated
03/20/2024
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