Provider Demographics
NPI:1659565398
Name:WALIA, MANJIT (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MANJIT
Middle Name:
Last Name:WALIA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25050 AVENUE KEARNY
Mailing Address - Street 2:SUITE 114
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1255
Mailing Address - Country:US
Mailing Address - Phone:661-204-9950
Mailing Address - Fax:
Practice Address - Street 1:25050 AVENUE KEARNY
Practice Address - Street 2:SUITE 114
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1255
Practice Address - Country:US
Practice Address - Phone:661-204-9950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23225103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical