Provider Demographics
NPI:1730296419
Name:STOESSEL, PAULA (PHD)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:STOESSEL
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 1:520 S SEPULVEDA BLVD STE 403
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-3548
Mailing Address - Country:US
Mailing Address - Phone:310-806-0707
Mailing Address - Fax:
Practice Address - Street 1:520 S SEPULVEDA BLVD STE 403
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-3548
Practice Address - Country:US
Practice Address - Phone:310-806-0707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13356103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY133560Medicaid
CAPSY133560Medicaid
CACP13356ZMedicare PIN