Provider Demographics
NPI:1083656441
Name:VAPNIK, TANYA (PHD)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:VAPNIK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5767 W CENTURY BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5632
Mailing Address - Country:US
Mailing Address - Phone:310-699-2619
Mailing Address - Fax:310-209-0444
Practice Address - Street 1:10850 WILSHIRE BLVD
Practice Address - Street 2:SUITE 1260
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-4305
Practice Address - Country:US
Practice Address - Phone:310-699-2619
Practice Address - Fax:310-209-0444
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-11
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17275103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP17275Medicare ID - Type UnspecifiedMEDICARE ID