MEDICARE: MARIKA REZNICHEK

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	106H00000X	Marriage & Family Therapist
2	106H00000X	Marriage & Family Therapist	122808	CA

General Provider Information

NPI Number	:	1588102255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIKA REZNICHEK

Provider Business Mailing Address
First Line	:	2006 N SEPULVEDA BLVD
Second Line	:
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90266-2906
Country	:	US
Telephone Number	:	310-221-6336
Fax Number	:

Provider Business Practice Location Address
First Line	:	2006 N SEPULVEDA BLVD # 1061
Second Line	:
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90266-2906
Country	:	US
Telephone Number	:	310-221-6336
Fax Number	:

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

Provider Enumeration Date	:	02/02/2017
Last Update Date	:	05/12/2025

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Directions to “ MARIKA REZNICHEK ” Practice Location

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