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Individual

MS. BETTY JEAN MATHIS

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
13400 RIVERSIDE DR, STE 310, SHERMAN OAKS, CA 91423-2544
(818) 386-9028
(818) 386-9029
Mailing address
13400 RIVERSIDE DR, STE 310, SHERMAN OAKS, CA 91423-2544
(818) 386-9028
(818) 386-9029

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY12093
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PSY120930
CA
Enumeration date
12/06/2005
Last updated
07/08/2007
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