Allan Gerson, PH.D.
Individual provider Active NPI Clinical Psychologist · N Hollywood, CA
NPI 1710396262 · NPPES record last updated Aug 8, 2014
Key facts
- NPI
- 1710396262
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY3338 (CA)
- Practice address
- 12520 Magnolia Blvd Ste 302
N Hollywood, CA 91607-2353 - Phone
- (818) 416-8078
- Fax
- (818) 995-8358
- NPI assigned
- Aug 8, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY3338 | CA | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY3338 | CA | Yes |
Addresses
Primary practice location
12520 Magnolia Blvd Ste 302
N Hollywood, CA 91607-2353
Mailing address
4935 Libbit Ave
Encino, CA 91436-1205
Phone (818) 416-8078
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All providers in N Hollywood, CA · Clinical Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.