Individual
DR. BETTYE FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
4859 W SLAUSON AVE STE 711, LOS ANGELES, CA 90056-1290
(323) 380-8189
Mailing address
4859 W SLAUSON AVE STE 711, LOS ANGELES, CA 90056-1290
(323) 380-8189
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY32406
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY32406
BOARD OF PSYCHOLOGY
CA
Enumeration date
03/08/2021
Last updated
03/08/2021
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