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General NPI Number Information
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NPI Number | 1063611044
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Entity Type | Individual
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Provider Name | SINDY OH-LIVERANT PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 01/30/2020
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Provider Practice Location Address
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Address Line | 12011 SAN VICENTE BLVD SUITE 408
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City | LOS ANGELES
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State | CA
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Zip | 90049-4926
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Country | US
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Telephone | 310-694-8470
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Fax |
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Provider Business Mailing Address
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Address Line | 13071 W ICON CIR
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City | PLAYA VISTA
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State | CA
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Zip | 90094-2070
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Country | US
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Telephone | 310-422-9147
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 24399
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License Number State | CA
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