Provider Demographics
NPI:1912278672
Name:FEIRSTEIN, MAX G (PHD)
Entity Type:Individual
Prefix:DR
First Name:MAX
Middle Name:G
Last Name:FEIRSTEIN
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 1:9107 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 475
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5531
Mailing Address - Country:US
Mailing Address - Phone:310-773-0010
Mailing Address - Fax:
Practice Address - Street 1:9107 WILSHIRE BLVD
Practice Address - Street 2:SUITE 475
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5531
Practice Address - Country:US
Practice Address - Phone:310-773-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY24699103T00000X, 103TB0200X, 103TC0700X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy