Healthcare Provider Details

I. General information

NPI: 1184678542
Provider Name (Legal Business Name): TANYA PAPARELLA PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MEDICAL PLAZA
LOS ANGELES CA
90095-0001
US

IV. Provider business mailing address

FILE 2939
LOS ANGELES CA
90074-0001
US

V. Phone/Fax

Practice location:
  • Phone: 310-825-9989
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberPSY 20332
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY20332
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: