Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PSY16034 | CA |
N | 103TC0700X | Clinical Psychologist | PSY16034 | CA |
Y | 102L00000X | Psychologist | PSY16034 | CA |
Y | 103T00000X | Psychologist | PSY16034 | CA |
N | 103TF0200X | Forensic Psychologist | PSY16034 | CA |
N | 103TH0100X | Health Service | PSY16034 | CA |
NPI | 1093787681 |
---|---|
Provider Name | Dr. Deborah Elaine Anderson |
First Address | Sherman Oaks, CA 91403-2201 |
Second Address | Sherman Oaks, CA 91403-2201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 17/02/2015 |