Provider Demographics
NPI:1275969057
Name:SCHORE, ALLAN NELSON (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:NELSON
Last Name:SCHORE
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 1:9817 SYLVIA AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-1760
Mailing Address - Country:US
Mailing Address - Phone:818-886-4368
Mailing Address - Fax:818-349-4404
Practice Address - Street 1:9817 SYLVIA AVE
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-1760
Practice Address - Country:US
Practice Address - Phone:818-886-4368
Practice Address - Fax:818-349-4404
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY3708103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical