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Organization

NICHOLAS S. THALER PHD A PSYCHOLOGICAL CORPORATION

Active
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Organization

NICHOLAS S. THALER PHD A PSYCHOLOGICAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICHOLAS THALER PHD (ORGANIZATION OFFICIAL)
(310) 570-5113
Entity
Organization

Contact information

Practice address
1526 14TH ST STE 109, SANTA MONICA, CA 90404-3320
(310) 570-5113
Mailing address
2950 S BENTLEY AVE APT 10, LOS ANGELES, CA 90064-4072
(310) 570-5113

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary

Other

Enumeration date
03/25/2020
Last updated
03/25/2020
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