Act5 Community Liaison Corp

NPI #1568222776 in Palos Verdes Pen, California

Provider Information

NPI Number: 1568222776
Entity Type: Organization
Organization Name: Act5 Community Liaison Corp
Primary Specialty: Psychologist
Enumeration Date: Mar 22, 2024
Last Updated: Apr 6, 2024

Practice Location

Address: 955 DEEP VALLEY DR
Address 2: STE 2411
City: Palos Verdes Pen
State: California
ZIP Code: 90274
Phone: (424) 262-7775

Authorized Official

Name: DR. KALINA NOELLE, PSYD
Title: PSYCHOLOGIST
Phone: (424) 262-7775

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical Child & Adolescent — Clinical Child & Adolescent	103TC2200X
Psychologist	103T00000X	Primary

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