MEDICARE: DR. DEBORAH WILLSON BILDER 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
1	103T00000X	Psychologist	19038	CA

General Provider Information

NPI Number	:	1508526500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORAH WILLSON BILDER PHD

Provider Business Mailing Address
First Line	:	2444 WILSHIRE BLVD STE 502
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-5809
Country	:	US
Telephone Number	:	310-826-8889
Fax Number	:

Provider Business Practice Location Address
First Line	:	2444 WILSHIRE BLVD STE 502
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-5809
Country	:	US
Telephone Number	:	310-826-8889
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2021
Last Update Date	:	12/19/2021

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