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General NPI Number Information
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NPI Number | 1811478266
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Entity Type | Individual
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Provider Name | AMANDA FRANCINE LOMANOV PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 08/23/2018
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Last Update Date | 08/23/2018
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Provider Practice Location Address
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Address Line | 1555 W SUNSET BLVD STE C
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City | LOS ANGELES
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State | CA
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Zip | 90026-3333
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Country | US
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Telephone | 914-230-0897
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Fax |
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Provider Business Mailing Address
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Address Line | 286 N MADISON AVE UNIT 316
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City | PASADENA
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State | CA
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Zip | 91101-4453
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Country | US
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Telephone |
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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 | PSB94024291
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License Number State | CA
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