Provider Demographics
NPI:1932597614
Name:LAUREN MUHLHEIM
Entity Type:Organization
Organization Name:LAUREN MUHLHEIM
Other - Org Name:EATING DISORDER THERAPY LA: A PSYCHOLOGY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:SIEGLER
Authorized Official - Last Name:MUHLHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:323-743-1122
Mailing Address - Street 1:4929 WILSHIRE BLVD STE 1000
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-3825
Mailing Address - Country:US
Mailing Address - Phone:323-743-1122
Mailing Address - Fax:
Practice Address - Street 1:4929 WILSHIRE BLVD STE 1000
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-3825
Practice Address - Country:US
Practice Address - Phone:323-743-1122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-02
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15045103TC0700X
CAPSY26716103TC0700X
CA861538133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1932597614OtherTYPE 2 NPI