Wasserman, Charles Brent

Wasserman, Charles Brent is an individual health care provider with primary practice located at 19542 Mayall St , Northridge CA 91324-1014. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Wasserman, Charles Brent can be contacted via phone (818) 718-9705.

Contact Information

Primary practice address
19542 Mayall St Northridge CA 91324-1014
Phone: (818) 718-9705
Fax: (818) 718-2276
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY5722 California

Profile Details

NPI number 1659361731
LBN Legal business name Wasserman, Charles Brent
Credentials PH. D.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 28th, 2005
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659361731 NPPES
California MEDICAID 00PL57220
California Other 00PL57220

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