Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY13568 | CA |
Y | 103T00000X | Psychologist | PSY13568 | CA |
NPI | 1013049105 |
---|---|
Provider Name | Dr. Genine Ivy Hanin |
First Address | Westlake Village, CA 91362-3571 |
Second Address | Westlake Village, CA 91362-3626 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2007 |
Last Update Date | 29/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R16720 | (02) | CA |