Healthcare Provider Details

I. General information

NPI: 1336244185
Provider Name (Legal Business Name): SHIRLEY LEVY PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 SOUTH MOUNTAIN AVE
DURATE CA
91010
US

IV. Provider business mailing address

13263 VENTURA BLVD #2
STUDIO CITY CA
91604-1839
US

V. Phone/Fax

Practice location:
  • Phone: 626-357-3207
  • Fax: 626-301-9590
Mailing address:
  • Phone: 818-501-6090
  • Fax: 818-501-6095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPX009285
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: