MEDICARE: DR. EVERLYN A. HUNTER PSY.D., M.S.

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	1317875	CA
2	103TB0200X	Cognitive & Behavioral Psychologist	1317875	CA
3	103TC2200X	Clinical Child & Adolescent Psychologist	1317875	CA

General Provider Information

NPI Number	:	1609010057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EVERLYN A. HUNTER PSY.D., M.S.

Provider Business Mailing Address
First Line	:	2117 S SPAULDING AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90016-1028
Country	:	US
Telephone Number	:	323-541-8523
Fax Number	:

Provider Business Practice Location Address
First Line	:	2117 S SPAULDING AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90016-1028
Country	:	US
Telephone Number	:	323-541-8523
Fax Number	:

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

Provider Enumeration Date	:	04/29/2009
Last Update Date	:	04/29/2009

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