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General NPI Number Information
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NPI Number | 1730394701
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Entity Type | Individual
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Provider Name | MARA L. SILVERMAN PHD
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Gender | Female
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Dates
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Enumeration Date | 05/13/2007
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Last Update Date | 04/23/2019
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Provider Practice Location Address
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Address Line | 1554 S SEPULVEDA BLVD STE 211
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City | LOS ANGELES
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State | CA
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Zip | 90025
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Country | US
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Telephone | 310-477-8888
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Fax |
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Provider Business Mailing Address
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Address Line | 9627 FARRAGUT DR
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City | CULVER CITY
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State | CA
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Zip | 90232-2823
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Country | US
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Telephone | 310-841-0810
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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 | PSY 15759
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License Number State | CA
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