Provider Demographics
NPI:1962455246
Name:BOYLE, PAUL A (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:BOYLE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
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Mailing Address - Street 1:847 5TH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-1351
Mailing Address - Country:US
Mailing Address - Phone:310-394-2586
Mailing Address - Fax:310-895-7644
Practice Address - Street 1:1137 2ND ST
Practice Address - Street 2:SUITE 207
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5011
Practice Address - Country:US
Practice Address - Phone:310-394-2586
Practice Address - Fax:310-895-7644
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY09193103TC0700X
CAMFC 13759106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist