Healthcare Provider Details

I. General information

NPI: 1093867111
Provider Name (Legal Business Name): PATRICIA LAFFERTY PH D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6021 WEEPING BANYAN LN
WOODLAND HILLS CA
91367-7255
US

IV. Provider business mailing address

6021 WEEPING BANYAN LN
WOODLAND HILLS CA
91367-7255
US

V. Phone/Fax

Practice location:
  • Phone: 310-208-1151
  • Fax:
Mailing address:
  • Phone: 310-208-1151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY11216
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: