Provider Demographics
NPI:1891079042
Name:LEVI, ORI (PHD)
Entity Type:Individual
Prefix:DR
First Name:ORI
Middle Name:
Last Name:LEVI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1495 N LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-2303
Mailing Address - Country:US
Mailing Address - Phone:646-480-6913
Mailing Address - Fax:
Practice Address - Street 1:1495 NORTH LAKE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104
Practice Address - Country:US
Practice Address - Phone:646-480-6913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist