LAWRENCE PESKIN


Address: 10114 Empyrean Way, Apt. 204, Los Angeles, CA 90067-3830
Phone: 4402817271

LAWRENCE PESKIN (NPI# 1477004794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1477004794
Entity Type Individual
Full Name LAWRENCE PESKIN
Credential PSY.D.
Practice Address 10114 Empyrean Way
Apt. 204
Los Angeles
CA 90067-3830
Practice Telephone 4402817271
Mailing Telephone 4402817271
Enumeration Date 2016-10-21
Last Update Date 2016-10-21
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC0700X Psychologist
Specialization: Clinical
PSY28318 CA Behavioral Health & Social Service Providers

Office Location

Street Address 10114 EMPYREAN WAY
APT. 204
City LOS ANGELES
State CA
Zip Code 90067-3830

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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

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Competitor

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City LOS ANGELES
Zip Code 90067

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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