Individual
DR. ILISSA E GREENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
11980 SAN VICENTE BLVD, SUITE 710, LOS ANGELES, CA 90049-5012
(310) 871-0042
Mailing address
11980 SAN VICENTE BLVD, SUITE 710, LOS ANGELES, CA 90049-5012
(310) 871-0042
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
12/15/2009
Last updated
05/27/2014
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