MEDICARE: SILVER LAKE PSYCHOTHERAPY PC

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	1041C0700X	Clinical Social Worker
2	106H00000X	Marriage & Family Therapist
3	251S00000X	Community/Behavioral Health Agency	PSY-23766	CA
4	261QM0850X	Adult Mental Health Clinic/Center
5	102L00000X	Psychoanalyst
6	103T00000X	Psychologist
7	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1952829418	OTHER	CA	ALISON DAVIES

General Provider Information

NPI Number	:	1922419548
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SILVER LAKE PSYCHOTHERAPY PC

Provider Business Mailing Address
First Line	:	1934 HILLHURST AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-2712
Country	:	US
Telephone Number	:	323-244-2066
Fax Number	:	323-275-0952

Provider Business Practice Location Address
First Line	:	1934 HILLHURST AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-2712
Country	:	US
Telephone Number	:	323-244-2066
Fax Number	:	323-275-0952

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	JUSTIN SHUBERT
Credential	:
Telephone Number	:	323-244-2066

Provider Enumeration Date	:	05/16/2014
Last Update Date	:	12/14/2023

Similar Medicare Providers

1669845012 — CLARISSA KNUDSON
Practice Location Address:

1934 HILLHURST AVE
LOS ANGELES, CA
90027-2712

Practice Phone: 310-304-2423
Practice Fax: 310-304-2423

1063452894 — DR. PHILIP ANTHONY RICCHIAZZI JR. D.C.
Practice Location Address:

1940 HILLHURST AVE
LOS ANGELES, CA
90027-2712

Practice Phone: 323-345-6030
Practice Fax:

1033244819 — DR. GRIGOR GEORGE SARKISSIAN DDS
Practice Location Address:

1912 HILLHURST AVE , SUITE A
LOS ANGELES, CA
90027-2712

Practice Phone: 323-662-8835
Practice Fax: 323-662-8892

1144437930 — GRIGOR G. SARKISSIAN, DDS, APC
Practice Location Address:

1912 HILLHURST AVE , SUITE A
LOS ANGELES, CA
90027-2712

Practice Phone: 323-662-8835
Practice Fax: 323-662-8892

1861737447 — LARA SAYLES M.A., LMFT
Practice Location Address:

1910 HILLHURST AVE
LOS ANGELES, CA
90027-2712

Practice Phone: 818-600-1116
Practice Fax:

1285069658 — DEISI ROHSIG-MOESER LCSW
Practice Location Address:

1920 HILLHURST AVE , STE 1180
LOS ANGELES, CA
90027-2712

Practice Phone: 310-592-3982
Practice Fax:

1487080412 — CORINNE EISENHARDT
Practice Location Address:

1910 HILLHURST AVE
LOS ANGELES, CA
90027-2712

Practice Phone: 818-660-5862
Practice Fax:

Directions to “SILVER LAKE PSYCHOTHERAPY PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.