MEDICARE: DR. BARBRA PAYNE PSY.D.

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	103TC0700X	Clinical Psychologist	PSY17156	CA

General Provider Information

NPI Number	:	1841217452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBRA PAYNE PSY.D.

Provider Business Mailing Address
First Line	:	9300 WILSHIRE BLVD
Second Line	:	SUITE 306
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-3213
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9300 WILSHIRE BLVD
Second Line	:	SUITE 306
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-3213
Country	:	US
Telephone Number	:	323-496-6488
Fax Number	:

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/08/2007

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