Provider Demographics
NPI:1477019180
Name:ALLEN, LASHEINATE (M-PSY)
Entity Type:Individual
Prefix:
First Name:LASHEINATE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:M-PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 E 67TH ST
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302-1813
Mailing Address - Country:US
Mailing Address - Phone:310-946-3755
Mailing Address - Fax:
Practice Address - Street 1:12522 MOORPARK ST
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-1355
Practice Address - Country:US
Practice Address - Phone:310-946-3755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-18
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician