=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801109822
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHERYL GENETA FELIX PSYD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/19/2010
-----------------------------------------------------
Last Update Date | 12/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 617 S OLIVE ST STE 200
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90014-1646
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 213-430-9080
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 617 S OLIVE ST STE 200
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90014-1646
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-921-0383
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | PSY33976
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------