Provider Demographics
NPI:1588721047
Name:DENHAM, WENDY ANN (PSY)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:ANN
Last Name:DENHAM
Suffix:
Gender:F
Credentials:PSY
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:ANN
Other - Last Name:HAFFNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSY
Mailing Address - Street 1:6310 SAN VICENTE BLVD
Mailing Address - Street 2:SUITE 415
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:310-657-6800
Mailing Address - Fax:310-861-1441
Practice Address - Street 1:6310 SAN VICENTE BLVD
Practice Address - Street 2:SUITE 415
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:310-657-6800
Practice Address - Fax:310-861-1441
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20898103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist