Provider Demographics
NPI:1326148230
Name:COHEN, MICHELLE (PHD)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:COHEN
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 1:22287 MULHOLLAND HWY
Mailing Address - Street 2:#214
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-5157
Mailing Address - Country:US
Mailing Address - Phone:310-473-2060
Mailing Address - Fax:310-473-0250
Practice Address - Street 1:2001 S BARRINGTON AVE
Practice Address - Street 2:#304
Practice Address - City:WEST LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5363
Practice Address - Country:US
Practice Address - Phone:310-473-2060
Practice Address - Fax:310-473-0250
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21127103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical