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Individual

DR. BARBARA ELLEN FANNIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
4929 WILSHIRE BLVD, SUITE NUMBER 510, LOS ANGELES, CA 90010-3808
(562) 904-3999
(855) 688-6746
Mailing address
4929 WILSHIRE BLVD, SUITE NUMBER 510, LOS ANGELES, CA 90010-3808
(562) 904-3999
(855) 688-6746

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
0172541
NY
103T00000X
Psychologist
1050
HI
103TC0700X
Clinical Psychologist
1293
NM
103TC0700X
Clinical Psychologist
Primary
PSY26371
CA

Other

Enumeration date
08/07/2007
Last updated
03/18/2021
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