Healthcare Provider Details

I. General information

NPI: 1881827798
Provider Name (Legal Business Name): MAYA SHLANGER B.S., M.A., PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2009
Last Update Date: 05/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2035 WESTWOOD BLVD ST 208
LOS ANGELES CA
90025-6332
US

IV. Provider business mailing address

2035 WESTWOOD BLVD
LOS ANGELES CA
90025-6332
US

V. Phone/Fax

Practice location:
  • Phone: 310-902-6449
  • Fax:
Mailing address:
  • Phone: 310-902-6449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: