Provider Demographics
NPI:1780222059
Name:MOJSILOVIC, NEVENA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NEVENA
Middle Name:
Last Name:MOJSILOVIC
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 1:1104 N MONTEREY ST APT J
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-1020
Mailing Address - Country:US
Mailing Address - Phone:323-351-8285
Mailing Address - Fax:
Practice Address - Street 1:107 S FAIR OAKS AVE STE 223229
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2010
Practice Address - Country:US
Practice Address - Phone:626-692-1531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31504103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical