Individual
NICOLE PHYLLIS BERMENSOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
10586 W PICO BLVD # 257, LOS ANGELES, CA 90064-2332
(424) 271-5221
Mailing address
10586 W PICO BLVD # 257, LOS ANGELES, CA 90064-2332
(424) 271-5221
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
132721
CA
Other
Enumeration date
05/31/2022
Last updated
10/09/2022
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