Provider Demographics
NPI:1447279799
Name:PRESSMAN, LEAH (PHD)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:PRESSMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 GAYLEY AVE STE 117
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-3417
Mailing Address - Country:US
Mailing Address - Phone:310-430-3202
Mailing Address - Fax:
Practice Address - Street 1:1033 GAYLEY AVE STE 117
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-3417
Practice Address - Country:US
Practice Address - Phone:310-430-3202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18124103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY181240OtherMEDI CAL
CAGT569ZMedicare PIN
CAWCP18124AMedicare ID - Type Unspecified