Provider Demographics
NPI:1124841382
Name:CALLAHAM, ARTIS MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:ARTIS
Middle Name:MARIE
Last Name:CALLAHAM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5361 OVERDALE DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043-2022
Mailing Address - Country:US
Mailing Address - Phone:562-480-7251
Mailing Address - Fax:
Practice Address - Street 1:5830 OVERHILL DR STE 2
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90043-2710
Practice Address - Country:US
Practice Address - Phone:213-424-2497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2673103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty