MEDICARE: BRICKLIN PSYCHOLOGICAL SERVICES, INC.

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

General Provider Information

NPI Number	:	1306990403
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRICKLIN PSYCHOLOGICAL SERVICES, INC.

Provider Business Mailing Address
First Line	:	22287 MULHOLLAND HWY
Second Line	:	#79
City	:	CALABASAS
State	:	CA
Zip	:	91302-5157
Country	:	US
Telephone Number	:	818-332-2287
Fax Number	:	818-332-2287

Provider Business Practice Location Address
First Line	:	23068 LANARK ST
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91304-3527
Country	:	US
Telephone Number	:	818-332-2287
Fax Number	:	818-332-2287

Authorized Official
Title or Position	:	CO-DIRECTOR
Name	:	DR. SETH BRICKLIN
Credential	:	PSY.D.
Telephone Number	:	818-332-2287

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	08/22/2020

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