Provider Demographics
NPI:1760551279
Name:BRUCE, PAULA EVADNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:EVADNE
Last Name:BRUCE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:360 N BEDFORD DR
Mailing Address - Street 2:SUITE 219
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5129
Mailing Address - Country:US
Mailing Address - Phone:310-271-2275
Mailing Address - Fax:310-271-2249
Practice Address - Street 1:360 N BEDFORD DR
Practice Address - Street 2:SUITE 219
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5129
Practice Address - Country:US
Practice Address - Phone:310-271-2275
Practice Address - Fax:310-271-2249
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16248103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical