Provider Demographics
NPI:1437168085
Name:WEINSTEIN, RICHARD STEPHEN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:STEPHEN
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13323 W WASHINGTON BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-5170
Mailing Address - Country:US
Mailing Address - Phone:310-577-9774
Mailing Address - Fax:310-641-4416
Practice Address - Street 1:13323 W WASHINGTON BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5170
Practice Address - Country:US
Practice Address - Phone:310-577-9774
Practice Address - Fax:310-641-4416
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16609103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical