Provider Demographics
NPI:1306999404
Name:KLEE, MARIANNE PESCI (PSYD)
Entity type:Individual
Prefix:DR
First Name:MARIANNE
Middle Name:PESCI
Last Name:KLEE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MARIANNE
Other - Middle Name:PESCI
Other - Last Name:KLEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:14112 S KINGSLEY DR
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90249-3018
Mailing Address - Country:US
Mailing Address - Phone:310-217-7325
Mailing Address - Fax:310-351-3111
Practice Address - Street 1:14112 S. KINGSLEY DRIVE
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90249
Practice Address - Country:US
Practice Address - Phone:310-217-7325
Practice Address - Fax:310-351-3111
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 18319103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical