Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY7497 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY7497 | CA |
NPI | 1003843996 |
---|---|
Provider Name | Dr. Bobbie Z Lesser |
First Address | Hermosa Beach, CA 90254 |
Second Address | Hermosa Beach, CA 90254 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PSY7497 | PSYCHOLOGY LIC (01) | CA |