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General NPI Number Information
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NPI Number | 1366955700
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Entity Type | Organization
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Legal Business Name | BILLIE WEISER, INC
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Dates
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Enumeration Date | 11/07/2017
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Last Update Date | 11/07/2017
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Provider Practice Location Address
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Address Line | 1328 WESTWOOD BLVD STE 2
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City | LOS ANGELES
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State | CA
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Zip | 90024-4932
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Country | US
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Telephone | 310-245-0550
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Fax |
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Provider Business Mailing Address
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Address Line | 1328 WESTWOOD BLVD STE 2
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City | LOS ANGELES
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State | CA
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Zip | 90024-4932
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Country | US
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Telephone | 310-245-0550
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BILLIE WEISER
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Credential | PSY.D
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Telephone | 310-245-0550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MF28800
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License Number State | CA
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