Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY28154 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY28154 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist |
NPI | 1023241957 |
---|---|
Provider Name | Ms. Myan Le |
First Address | Torrance, CA 90503-6705 |
Second Address | Long Beach, CA 90804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2009 |
Last Update Date | 08/04/2021 |