Individual
DAVID WELLISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
450 N BEDFORD DR STE 310, BEVERLY HILLS, CA 90210-4307
(310) 710-6432
(323) 375-3204
Mailing address
5767 W CENTURY BLVD, SUITE 200, LOS ANGELES, CA 90045-5632
(310) 301-8708
(310) 301-8751
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY4936
CA
103TC0700X
Clinical Psychologist
Primary
PSY4936
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PSY49360
MEDICAL
CA
Enumeration date
08/12/2006
Last updated
08/08/2024
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