MEDICARE: RYCKAYLA ADRYANA COPELAND

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	372600000X	Adult Companion

General Provider Information

NPI Number	:	1720323140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYCKAYLA ADRYANA COPELAND

Provider Business Mailing Address
First Line	:	3784 S BRONSON AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90018-4007
Country	:	US
Telephone Number	:	323-481-7747
Fax Number	:

Provider Business Practice Location Address
First Line	:	3784 S BRONSON AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90018-4007
Country	:	US
Telephone Number	:	323-481-7747
Fax Number	:

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

Provider Enumeration Date	:	12/11/2012
Last Update Date	:	02/04/2026

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