Provider Demographics
NPI:1407224512
Name:GOTTUSO, ANN YEH (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:YEH
Last Name:GOTTUSO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 512717
Mailing Address - Street 2:CEDARS-SINAI MEDICAL CENTER PBS
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90051-0717
Mailing Address - Country:US
Mailing Address - Phone:310-967-1884
Mailing Address - Fax:310-967-1880
Practice Address - Street 1:8700 BEVERLY BLVD STE 7215
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-1804
Practice Address - Country:US
Practice Address - Phone:310-423-3933
Practice Address - Fax:310-423-9722
Is Sole Proprietor?:No
Enumeration Date:2015-09-04
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA26501103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist