MEDICARE: DR. ELAINE SCHULMAN PH.D.

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
1	103TC0700X	Clinical Psychologist	PSY6330	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PSY6330	OTHER	CA	LICENSE NUMBER

General Provider Information

NPI Number	:	1952426207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELAINE SCHULMAN PH.D.

Provider Business Mailing Address
First Line	:	1314 WESTWOOD BLVD
Second Line	:	SUITE 201
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-4902
Country	:	US
Telephone Number	:	310-475-0674
Fax Number	:

Provider Business Practice Location Address
First Line	:	1314 WESTWOOD BLVD
Second Line	:	SUITE 201
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-4902
Country	:	US
Telephone Number	:	310-475-0674
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/08/2007

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