Healthcare Provider Details

I. General information

NPI: 1710785720
Provider Name (Legal Business Name): ANNIE REINER PH.D., PSY.D., LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2025
Last Update Date: 03/05/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

436 N. ROXBURY DRIVE #208
BEVERLY HILLS CA
90210-5026
US

IV. Provider business mailing address

436 N. ROXBURY DRIVE #208
BEVERLY HILLS CA
90210-5026
US

V. Phone/Fax

Practice location:
  • Phone: 310-721-2045
  • Fax:
Mailing address:
  • Phone: 310-721-2045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License NumberLCS6583
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: