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NPI Code Detail

MEDICARE: DR. JUDITH ANN LAFFERTY PHD

MEDICARE:  DR. JUDITH ANN LAFFERTY  PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPSY13723CA

General Provider Information

NPI Number : 1053514620
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUDITH ANN LAFFERTY PHD
Provider Business Mailing Address
First Line : 8621 BELLANCA AVE
Second Line : STE. 215
City : LOS ANGELES
State : CA
Zip : 90045-4418
Country : US
Telephone Number : 310-641-1633
Fax Number : 310-216-7524
Provider Business Practice Location Address
First Line : 8621 BELLANCA AVE
Second Line : STE. 215
City : LOS ANGELES
State : CA
Zip : 90045-4418
Country : US
Telephone Number : 310-641-1633
Fax Number : 310-216-7524
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2007
Last Update Date : 07/08/2007

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Directions to “ DR. JUDITH ANN LAFFERTY PHD” Practice Location

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