Provider Demographics
NPI:1841550928
Name:COZOLINO, LOUIS JOHN II (PHD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:JOHN
Last Name:COZOLINO
Suffix:II
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:LOUIS
Other - Middle Name:JOHN
Other - Last Name:COZOLINO
Other - Suffix:II
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:360 NORTH BEDFORD DRIVE
Mailing Address - Street 2:SUITE 312
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5121
Mailing Address - Country:US
Mailing Address - Phone:310-273-6248
Mailing Address - Fax:
Practice Address - Street 1:360 N BEDFORD DR
Practice Address - Street 2:SUITE 312
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5129
Practice Address - Country:US
Practice Address - Phone:310-273-6248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10266103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical