Individual
MICHAEL LERNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
19231 VICTORY BLVD, 554, RESEDA, CA 91335-6308
(818) 776-1755
Mailing address
7206 SHIRLEY AVE, UNIT 407, RESEDA, CA 91335-3477
(818) 554-8752
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196856000
—
CA
05
—
CMM70956F
—
CA
Enumeration date
10/16/2009
Last updated
10/16/2009
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