Individual
NEDA PETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2006 CANADA BLVD, GLENDALE, CA 91208-2532
(818) 300-8862
Mailing address
2006 CANADA BLVD, GLENDALE, CA 91208-2532
(818) 300-8862
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/14/2019
Last updated
09/19/2022
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