Healthcare Provider Details

I. General information

NPI: 1326390261
Provider Name (Legal Business Name): DANIELLE R PERRYMAN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DANIELLE R EDWARDS

II. Dates (important events)

Enumeration Date: 10/02/2012
Last Update Date: 05/30/2023
Certification Date: 05/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 VETERAN AVE RM 25-57
LOS ANGELES CA
90024-2704
US

IV. Provider business mailing address

1000 VETERAN AVE RM 25-57
LOS ANGELES CA
90024-2704
US

V. Phone/Fax

Practice location:
  • Phone: 310-825-6110
  • Fax:
Mailing address:
  • Phone: 310-825-6110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY31481
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: