Provider Demographics
NPI:1497825913
Name:ONODA, LAWRENCE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:
Last Name:ONODA
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 1:15545 DEVONSHIRE ST
Mailing Address - Street 2:STE 111
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345
Mailing Address - Country:US
Mailing Address - Phone:818-893-3800
Mailing Address - Fax:818-745-9848
Practice Address - Street 1:15545 DEVONSHIRE ST
Practice Address - Street 2:STE 111
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345
Practice Address - Country:US
Practice Address - Phone:818-893-3800
Practice Address - Fax:818-745-9848
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 4629103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2251918OtherMEDICAID UPIN
CA00PL46290Medicaid
CA2251918OtherMEDICAID UPIN
CACP 4629Medicare PIN