Provider Demographics
NPI:1790990661
Name:WEINER, LOREN ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LOREN
Middle Name:ANNE
Last Name:WEINER
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 1:450 N BEDFORD DR
Mailing Address - Street 2:SUITE 211
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4324
Mailing Address - Country:US
Mailing Address - Phone:310-271-7718
Mailing Address - Fax:
Practice Address - Street 1:450 N BEDFORD DR
Practice Address - Street 2:SUITE 211
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4324
Practice Address - Country:US
Practice Address - Phone:310-271-7718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20098103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical