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General NPI Number Information
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NPI Number | 1407933005
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Entity Type | Individual
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Provider Name | PAMELA SUE PINE PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 12/02/2011
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Provider Practice Location Address
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Address Line | 9735 WILSHIRE BLVD STE 212
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-2102
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Country | US
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Telephone | 310-275-1867
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Fax | 310-275-4838
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Provider Business Mailing Address
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Address Line | 9735 WILSHIRE BLVD STE 212
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-2102
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Country | US
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Telephone | 310-275-1867
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Fax | 310-275-4838
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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 | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | PSY16970
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License Number State | CA
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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 | PSY16970
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | PSY16970
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 103TP0814X
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Taxonomy Name | Psychoanalysis Psychologist
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License Number | PSY16970
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY6970
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number | PSY16970
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY16970
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License Number State | CA
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Taxonomy #8
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT17040
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License Number State | CA
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