Healthcare Provider Details

I. General information

NPI: 1962315515
Provider Name (Legal Business Name): DONNA PALL PSYCHOTHERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5439 RED OAK DR
LOS ANGELES CA
90068-2548
US

IV. Provider business mailing address

5439 RED OAK DR
LOS ANGELES CA
90068-2548
US

V. Phone/Fax

Practice location:
  • Phone: 818-340-2501
  • Fax: 818-340-2501
Mailing address:
  • Phone: 818-340-2501
  • Fax: 818-340-2501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DONNA RAY PALL
Title or Position: PRESIDENT
Credential: LCSW
Phone: 818-340-2501