Individual
CARRIE BEARDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
300 MEDICAL PLZ, LOS ANGELES, CA 90095-0001
(310) 825-9989
Mailing address
5767 W CENTURY BLVD, SUITE 200, LOS ANGELES, CA 90045-5632
(310) 825-9989
(310) 794-9517
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY20046
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PSY200460
—
CA
Enumeration date
07/11/2006
Last updated
04/25/2012
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