Doctor Name: | EILEEN M. MARONDE |
NPI Number: | 1013092964 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D |
License Number: | PSY 12985 |
Business Practice Address: | 7621 Canoga Ave Canoga Park, CA - 913044912 |
Business Phone Number: | 8185986900 |
Business Fax Number: | |
Mailing Address: | 7621 Canoga Ave, CANOGA PARK |
State: | CA |
Postal Code: | 913044912 |
Phone Number: | 8185986900 |
Fax Number: | 8185986977 |
NPI Enumeration Date: | 10/26/2006 |
NPI Last Update Date: | 09/06/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY 12985 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |