Provider Demographics
NPI:1245737154
Name:ACCORTT, EYNAV ELGAVISH (PHD)
Entity Type:Individual
Prefix:DR
First Name:EYNAV
Middle Name:ELGAVISH
Last Name:ACCORTT
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 1:444 S SAN VICENTE BLVD STE 1001
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-4170
Mailing Address - Country:US
Mailing Address - Phone:310-248-8460
Mailing Address - Fax:310-423-9939
Practice Address - Street 1:444 S SAN VICENTE BLVD STE 1001
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-4170
Practice Address - Country:US
Practice Address - Phone:310-248-8460
Practice Address - Fax:310-423-9939
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-07
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY28621103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical