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General NPI Number Information
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NPI Number | 1063725794
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Entity Type | Individual
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Provider Name | AMI ISRAEL STUDENT PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 07/22/2010
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 2250 S PALM CANYON DR UNIT 35
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City | PALM SPRINGS
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State | CA
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Zip | 92264-9376
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Country | US
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Telephone | 213-465-0040
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Fax |
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Provider Business Mailing Address
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Address Line | 645 W 9TH ST UNIT 110-170
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City | LOS ANGELES
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State | CA
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Zip | 90015-1640
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Country | US
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Telephone |
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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 | 202862
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3673
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 27086
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License Number State | CA
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