Provider Demographics
NPI:1396962015
Name:COHN, JUDITH REDLER (PHD)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:REDLER
Last Name:COHN
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 1:5050 OAKDALE AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-3629
Mailing Address - Country:US
Mailing Address - Phone:818-883-7374
Mailing Address - Fax:
Practice Address - Street 1:18345 VENTURA BLVD
Practice Address - Street 2:STE. 515
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-4232
Practice Address - Country:US
Practice Address - Phone:818-883-4313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13427103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY13427OtherBOARD OF PSYCHOLOGY LIC.
CACP13427OtherPIN