Provider Demographics
NPI:1528399060
Name:ZAYTSEV, LUDMILA (PHD)
Entity Type:Individual
Prefix:DR
First Name:LUDMILA
Middle Name:
Last Name:ZAYTSEV
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15335 MORRISON ST
Mailing Address - Street 2:STE 205
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1585
Mailing Address - Country:US
Mailing Address - Phone:323-682-8225
Mailing Address - Fax:323-729-3829
Practice Address - Street 1:15335 MORRISON ST
Practice Address - Street 2:STE 205
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1585
Practice Address - Country:US
Practice Address - Phone:323-682-8225
Practice Address - Fax:323-729-3829
Is Sole Proprietor?:No
Enumeration Date:2010-01-22
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23050103TC2200X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent