Doctor Name: | DR. STACY BERLIN |
NPI Number: | 1184641805 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | PSY16878 |
Business Practice Address: | 12301 Wilshire Blvd Suite 210 West Los Angeles, CA - 900251007 |
Business Phone Number: | 3104426466 |
Business Fax Number: | |
Mailing Address: | 4223 Vantage Ave, STUDIO CITY |
State: | CA |
Postal Code: | 916042066 |
Phone Number: | 3104426466 |
Fax Number: | |
NPI Enumeration Date: | 07/17/2006 |
NPI Last Update Date: | 06/21/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY16878 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |