Organization
PERSONA NEURO BEHAVIOR GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCEL O. PONTON PH.D. (PRESIDENT)
(626) 449-2484
Entity
Organization
Contact information
Practice address
625 FAIR OAKS AVENUE, SUITE 390, SOUTH PASADENA, CA 91030
(626) 449-2484
(626) 449-1107
Mailing address
625 FAIR OAKS AVE, SUITE 390, SOUTH PASADENA, CA 91030-2630
(626) 449-2484
(626) 449-1107
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY12133
CA
Other
Enumeration date
09/08/2006
Last updated
07/21/2015
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