Provider Demographics
NPI:1578458071
Name:ABBA CENTER, PSYCHOLOGICAL SERVICES, PC
Entity type:Organization
Organization Name:ABBA CENTER, PSYCHOLOGICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE OFFICERS, DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DORIBETH
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:ADAMS TARDILLO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:323-494-3762
Mailing Address - Street 1:609 DEEP VALLEY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3614
Mailing Address - Country:US
Mailing Address - Phone:323-494-3762
Mailing Address - Fax:
Practice Address - Street 1:609 DEEP VALLEY DR
Practice Address - Street 2:STE 200
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3614
Practice Address - Country:US
Practice Address - Phone:323-494-3762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)