Doctor Name: | DR. AMIE L CALLON |
NPI Number: | 1164807400 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | PSY26544 |
Business Practice Address: | 2100 N Sepulveda Blvd Suite 6 Manhattan Beach, CA - 902662948 |
Business Phone Number: | 3109903560 |
Business Fax Number: | 3105453000 |
Mailing Address: | 2100 N Sepulveda Blvd, Suite 6 MANHATTAN BEACH |
State: | CA |
Postal Code: | 902662948 |
Phone Number: | 3109903560 |
Fax Number: | 3105453000 |
NPI Enumeration Date: | 07/28/2015 |
NPI Last Update Date: | 07/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY26544 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |