Healthcare Provider Details

I. General information

NPI: 1033024435
Provider Name (Legal Business Name): WHITE COAT THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3019 OCEAN PARK BLVD STE 630
SANTA MONICA CA
90405-3004
US

IV. Provider business mailing address

3019 OCEAN PARK BLVD STE 630
SANTA MONICA CA
90405-3004
US

V. Phone/Fax

Practice location:
  • Phone: 213-373-4949
  • Fax:
Mailing address:
  • Phone: 213-373-4949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ANNIA WAHEED RAJA
Title or Position: PSYCHOLOGIST
Credential: PHD
Phone: 213-373-4949