Provider Demographics
NPI:1720440084
Name:TEBYANI, BITA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BITA
Middle Name:
Last Name:TEBYANI
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 1:9107 WILSHIRE BLVD STE 350
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5555
Mailing Address - Country:US
Mailing Address - Phone:310-285-8121
Mailing Address - Fax:310-285-8123
Practice Address - Street 1:9107 WILSHIRE BLVD STE 350
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5555
Practice Address - Country:US
Practice Address - Phone:310-285-8121
Practice Address - Fax:310-285-8123
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-25
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY27881103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist