MEDICARE: DR. KAREN S PAYNE PH.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	103T00000X	Psychologist	PL 10175	CA

General Provider Information

NPI Number	:	1972527844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN S PAYNE PH.D.

Provider Business Mailing Address
First Line	:	2288 MANNING AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-2002
Country	:	US
Telephone Number	:	310-474-3473
Fax Number	:	310-475-9659

Provider Business Practice Location Address
First Line	:	2288 MANNING AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-2002
Country	:	US
Telephone Number	:	310-474-3473
Fax Number	:	310-475-9659

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	07/08/2007

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