Individual provider · NPI-1

Alexander Gantman, Psy.D.

Psychologist · Valley Village, CA

NPI number1669609780
StatusActive
Last updated in NPPESAug 1, 2011

Details

NPI
1669609780
Entity type
Individual (NPI-1)
Name
Alexander Gantman
Credential
Psy.D.
Sex
Male
Sole proprietor
Yes
Enumeration date
Jun 16, 2009
Last updated
Aug 1, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103T00000X Psychologist––Yes

Practice location

12053 Emelita St
#7
Valley Village, CA 91607

Phone 323-547-6760

Mailing address

12053 Emelita St
#7
Valley Village, CA 91607

Phone 323-547-6760

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