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General NPI Number Information
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NPI Number | 1245737154
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Entity Type | Individual
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Provider Name | EYNAV ELGAVISH ACCORTT PHD
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Gender | Female
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Dates
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Enumeration Date | 04/07/2018
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Last Update Date | 04/01/2024
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Provider Practice Location Address
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Address Line | 444 S SAN VICENTE BLVD STE 1001
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City | LOS ANGELES
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State | CA
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Zip | 90048-4170
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Country | US
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Telephone | 310-248-8460
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Fax | 310-423-9939
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Provider Business Mailing Address
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Address Line | 444 S SAN VICENTE BLVD STE 1001
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City | LOS ANGELES
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State | CA
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Zip | 90048-4170
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Country | US
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Telephone | 310-248-8460
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Fax | 310-423-9939
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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 | PSY28621
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License Number State | CA
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