Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY 10619 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY 10619 | CA |
NPI | 1003967209 |
---|---|
Provider Name | Dr. Susan Himelstein |
First Address | Beverly Hills, CA 90210-5508 |
Second Address | Beverly Hills, CA 90210-5508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2007 |
Last Update Date | 08/07/2007 |