Healthcare Provider Details

I. General information

NPI: 1104751478
Provider Name (Legal Business Name): VERA LEVI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3580 WILSHIRE BLVD STE 2000
LOS ANGELES CA
90010-2533
US

IV. Provider business mailing address

12658 TIARA ST
VALLEY VILLAGE CA
91607-1023
US

V. Phone/Fax

Practice location:
  • Phone: 213-381-1250
  • Fax:
Mailing address:
  • Phone: 818-943-8808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: