Provider Demographics
NPI:1437353141
Name:FELDMAN, DAVID JAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JAN
Last Name:FELDMAN
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 1:3812 SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 340
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-2479
Mailing Address - Country:US
Mailing Address - Phone:310-613-9535
Mailing Address - Fax:310-303-7906
Practice Address - Street 1:3812 SEPULVEDA BLVD
Practice Address - Street 2:SUITE 340
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-2479
Practice Address - Country:US
Practice Address - Phone:310-613-9535
Practice Address - Fax:310-303-7906
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMM24418106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist