Individual
DR. RANDI ELISA BIENSTOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
9911 W PICO BLVD, SUITE 1480, LOS ANGELES, CA 90035-2703
(310) 659-3823
Mailing address
807 PROSPECT AVE, #202, SOUTH PASADENA, CA 91030-2457
(310) 659-3823
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
PSY15925
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY159250
MEDI-CAL
CA
Enumeration date
06/19/2007
Last updated
07/08/2007
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