Provider Demographics
NPI:1194026302
Name:ZINBERG, PERRI (PHD)
Entity Type:Individual
Prefix:DR
First Name:PERRI
Middle Name:
Last Name:ZINBERG
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 1:11944 MAYFIELD AVE
Mailing Address - Street 2:#305
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-5967
Mailing Address - Country:US
Mailing Address - Phone:424-248-7790
Mailing Address - Fax:
Practice Address - Street 1:12011 SAN VICENTE BLVD
Practice Address - Street 2:SUITE 402
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-4926
Practice Address - Country:US
Practice Address - Phone:424-248-7790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14218103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical