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General NPI Number Information
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NPI Number | 1932920873
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Entity Type | Organization
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Legal Business Name | THE BRAIN PSYCHOLOGIST PC
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Dates
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Enumeration Date | 10/23/2024
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 1845 GLENDON AVE APT 301
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City | LOS ANGELES
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State | CA
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Zip | 90025-4638
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Country | US
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Telephone | 310-933-2864
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Fax |
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Provider Business Mailing Address
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Address Line | 11301 W OLYMPIC BLVD # 121-430
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City | LOS ANGELES
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State | CA
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Zip | 90064-1653
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Country | US
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Telephone | 424-234-3032
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Fax |
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Authorized Official
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Title or Position | CLINICAL NEUROPSYCHOLOGIST
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Name | DR. LIORAH SABBAH
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Credential | PHD
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Telephone | 310-933-2864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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