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NPI Code Detail

MEDICARE: DR. ADRIENNE ERICA SALICK PSY.D.

MEDICARE: DR. ADRIENNE ERICA SALICK PSY.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
1103T00000XPsychologistPSY20857CA

General Provider Information

NPI Number : 1013036201
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ADRIENNE ERICA SALICK PSY.D.
Provider Business Mailing Address
First Line : 8631 W 3RD ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90048-5901
Country : US
Telephone Number : 310-488-8489
Fax Number :
Provider Business Practice Location Address
First Line : 4160 GRAND VIEW BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90066-5214
Country : US
Telephone Number : 310-751-1157
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2007
Last Update Date : 07/08/2007

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