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NPI Code Detail

MEDICARE: DR. EMILY TODD MD, PHD

MEDICARE: DR. EMILY TODD MD, PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0804XChild & Adolescent Psychiatry Physician4301500415MI
22084P0800XPsychiatry PhysicianA123697CA
32084P0800XPsychiatry Physician4301500415MI
42084P0804XChild & Adolescent Psychiatry PhysicianA123697CA
52084P0800XPsychiatry PhysicianME153218FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255625273
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EMILY TODD MD, PHD
Provider Business Mailing Address
First Line : 1626 MONTANA AVE STE 621
Second Line :
City : SANTA MONICA
State : CA
Zip : 90403-1808
Country : US
Telephone Number : 310-905-4055
Fax Number :
Provider Business Practice Location Address
First Line : 2101 COURAGE DR
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-6717
Country : US
Telephone Number : 707-784-2080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2011
Last Update Date : 04/27/2026

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Directions to “ DR. EMILY TODD MD, PHD” Practice Location

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