Provider Demographics
NPI:1871616557
Name:LERMAN, CHARLES ALBERT (PHD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ALBERT
Last Name:LERMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:16255 VENTURA BLVD
Mailing Address - Street 2:SUITE 806
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2302
Mailing Address - Country:US
Mailing Address - Phone:818-708-1801
Mailing Address - Fax:818-708-1801
Practice Address - Street 1:16255 VENTURA BLVD
Practice Address - Street 2:SUITE 806
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2302
Practice Address - Country:US
Practice Address - Phone:818-708-1801
Practice Address - Fax:818-708-1801
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 7040103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist