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General NPI Number Information
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NPI Number | 1104977875
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Entity Type | Individual
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Provider Name | SENIORA MATHEWS M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 04/18/2022
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Provider Practice Location Address
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Address Line | 468 N CAMDEN DR STE 353
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4507
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Country | US
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Telephone | 310-601-3074
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Fax |
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Provider Business Mailing Address
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Address Line | 3422 BUSINESS CENTER DR. STE 106 BOX 46
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City | PEARLAND
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State | TX
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Zip | 77584-0118
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Country | US
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Telephone | 870-530-1038
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 33788
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 17480
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | E2121
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License Number State | AR
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A93922
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License Number State | CA
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