Provider Demographics
NPI:1295076065
Name:VARADY, PAMELA (PSYD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:VARADY
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 1:3101 OCEAN PARK BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-3022
Mailing Address - Country:US
Mailing Address - Phone:310-766-1030
Mailing Address - Fax:
Practice Address - Street 1:3101 OCEAN PARK BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-3022
Practice Address - Country:US
Practice Address - Phone:310-766-1030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17575103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist