Healthcare Provider Details

I. General information

NPI: 1134277239
Provider Name (Legal Business Name): LORENA FRCEK PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 05/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11303 W WASHINGTON BLVD SUITE 200
LOS ANGELES CA
90066-6003
US

IV. Provider business mailing address

961 AMHERST AVE
LOS ANGELES CA
90049-5801
US

V. Phone/Fax

Practice location:
  • Phone: 310-482-6658
  • Fax: 310-313-0973
Mailing address:
  • Phone: 310-442-2630
  • Fax: 310-442-2859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: