Provider Demographics
NPI:1679721849
Name:REISNER, ARIELLA SANDRA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ARIELLA
Middle Name:SANDRA
Last Name:REISNER
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 1:4714 TOBIAS AVE
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2825
Mailing Address - Country:US
Mailing Address - Phone:818-990-5908
Mailing Address - Fax:818-990-5908
Practice Address - Street 1:4714 TOBIAS AVE
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2825
Practice Address - Country:US
Practice Address - Phone:818-990-5908
Practice Address - Fax:818-990-5908
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-30
Last Update Date:2008-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19354103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical