| Doctor Name: | DR. ANN FORISHA THIEL |
| NPI Number: | 1063620086 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | PSY 11416 |
| Business Practice Address: | 505 Paseo Miramar Pacific Palisades, CA - 902723020 |
| Business Phone Number: | 3104577606 |
| Business Fax Number: | |
| Mailing Address: | 505 Paseo Miramar, PACIFIC PALISADES |
| State: | CA |
| Postal Code: | 902723020 |
| Phone Number: | 3104577606 |
| Fax Number: | |
| NPI Enumeration Date: | 05/21/2007 |
| NPI Last Update Date: | 12/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TF0000X |
| License Number: | PSY 11416 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |