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Contact Information

ACT5 COMMUNITY LIAISON CORP
955 DEEP VALLEY DR
STE 2411
PALOS VERDES PEN, CA90274
 Phone: 424-262-7775
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
 

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for ACT5 COMMUNITY LIAISON CORP · (Female)

NPI # 1568222776
Status Active
Credentials
Entity Individual
Enumeration date 03/22/2024
Last updated 04/06/2024 - About 2 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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