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NPI Code Detail

MEDICARE: DR. RICHARD SANEDA PHD

MEDICARE: DR. RICHARD SANEDA 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
1103TC0700XClinical PsychologistPSY14078CA

General Provider Information

NPI Number : 1790816742
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD SANEDA PHD
Provider Business Mailing Address
First Line : 3031 S VERMONT AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90007-3033
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4401 CRENSHAW BLVD
Second Line : SUITE 300
City : LOS ANGELES
State : CA
Zip : 90043-1227
Country : US
Telephone Number : 323-290-8360
Fax Number : 323-290-8366
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2007
Last Update Date : 11/10/2016

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