Dr. Tyler Dean Waxman, Psy.D.

Psychologist, Clinical in Los Angeles, CA. Individual provider (NPI-1).

NPI number1497879720

StatusActive

Last updated in NPPESJul 8, 2007

Details

NPI: 1497879720
Entity type: Individual (NPI-1)
Name: Dr. Tyler Dean Waxman
Credential: Psy.D.
Sex: Male
Sole proprietor: No
Enumeration date: Mar 19, 2007
Last updated: Jul 8, 2007

Medicare and OIG

Medicare enrolled (PECOS): Not in the Medicare enrollment file
Can order and refer: Not on the CMS order and referring list
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
103TC0700X	Psychologist, Clinical	PSY 18571	CA	Yes

Practice location

5000 W Sunset Blvd
Suite 540m
Los Angeles, CA 90027-5861

Phone 323-669-2153 · Fax 323-913-3614

Mailing address

Po Box 54700
Mailstop #2
Los Angeles, CA 90054-0700

Phone 323-669-2153 · Fax 323-913-3614

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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