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General NPI Number Information
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NPI Number | 1780222059
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Entity Type | Individual
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Provider Name | NEVENA MOJSILOVIC PSYD
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Gender | Female
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Dates
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Enumeration Date | 12/17/2019
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Last Update Date | 12/17/2019
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Provider Practice Location Address
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Address Line | 107 S FAIR OAKS AVE STE 223229
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City | PASADENA
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State | CA
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Zip | 91105-2010
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Country | US
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Telephone | 626-692-1531
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Fax |
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Provider Business Mailing Address
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Address Line | 1104 N MONTEREY ST APT J
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City | ALHAMBRA
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State | CA
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Zip | 91801-1020
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Country | US
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Telephone | 323-351-8285
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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 | 31504
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License Number State | CA
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