Provider Demographics
NPI:1326439126
Name:EINBUND, NEIL (PHD,)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:
Last Name:EINBUND
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 1:18663 VENTURA BLVD STE 232
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-6801
Mailing Address - Country:US
Mailing Address - Phone:310-285-5048
Mailing Address - Fax:
Practice Address - Street 1:18663 VENTURA BLVD STE 232
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-6801
Practice Address - Country:US
Practice Address - Phone:310-285-5048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-15
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12611103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist