Provider Demographics
NPI:1962717082
Name:DINOBLE, AMY ALLYN (PHD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:ALLYN
Last Name:DINOBLE
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 1:1626 WESTWOOD BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-5621
Mailing Address - Country:US
Mailing Address - Phone:310-780-6603
Mailing Address - Fax:
Practice Address - Street 1:1626 WESTWOOD BLVD STE 102
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-5621
Practice Address - Country:US
Practice Address - Phone:310-780-6603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 24990103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist