Individual
D LOUISE MEBANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
153 SO LASKY DR, #8, BEVERLY HILLS, CA 90212
(310) 262-2033
(323) 933-5769
Mailing address
1628 ELLSMERE AVE, LOS ANGELES, CA 90019
(310) 262-2033
(323) 933-5769
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY12373
CA
103TC0700X
Clinical Psychologist
Primary
PSY12373
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PSY123732
—
CA
Enumeration date
06/28/2006
Last updated
03/05/2009
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