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General NPI Number Information
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NPI Number | 1902938426
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Entity Type | Individual
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Provider Name | BRYCE A MALEK PSYD
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Gender | Male
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Dates
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Enumeration Date | 03/10/2007
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Last Update Date | 08/26/2014
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Provider Practice Location Address
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Address Line | 4444 RIVERSIDE DRIVE #305
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City | BURBANK
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State | CA
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Zip | 91505
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Country | US
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Telephone | 818-769-1952
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Fax |
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Provider Business Mailing Address
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Address Line | 11333 MOORPARK STREET #149
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City | STUDIO CITY
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State | CA
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Zip | 91602
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Country | US
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Telephone | 818-769-1952
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY24611
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY 24611
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 35241
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License Number State | CA
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