Provider Demographics
NPI:1093922411
Name:WEISS, ABNER (PHD)
Entity Type:Individual
Prefix:DR
First Name:ABNER
Middle Name:
Last Name:WEISS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:392 NORCROFT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-2526
Mailing Address - Country:US
Mailing Address - Phone:310-446-0480
Mailing Address - Fax:310-446-0496
Practice Address - Street 1:392 NORCROFT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-2526
Practice Address - Country:US
Practice Address - Phone:310-446-0480
Practice Address - Fax:310-446-0496
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 32918106H00000X
NY000499106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist