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Individual

DR. BART LEE ROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D

Contact information

Practice address
16531 BOLSA CHICA ST, STE 314, HUNTINGTON BEACH, CA 92649-3596
(626) 963-4467
Mailing address
16531 BOLSA CHICA ST, STE 314, HUNTINGTON BEACH, CA 92649-3596
(323) 791-1808

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY15175
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00CP151750
CA
Enumeration date
06/23/2006
Last updated
02/17/2016
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