Healthcare Provider Details
I. General information
NPI: 1003958661
Provider Name (Legal Business Name): LINDSAY HELLER PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/12/2007
Last Update Date: 02/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9171 WILSHIRE BLVD STE 600
BEVERLY HILLS CA
90210-5523
US
IV. Provider business mailing address
9171 WILSHIRE BLVD STE 600
BEVERLY HILLS CA
90210-5523
US
V. Phone/Fax
- Phone: 310-384-9300
- Fax: 310-283-1010
- Phone: 310-384-9300
- Fax: 310-283-1010
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PSY21400 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC2200X |
| Taxonomy | Clinical Child & Adolescent Psychologist |
| License Number | PSY21400 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: