MEDICARE: DR. STACI R. EMERSON PH.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
1	103TC0700X	Clinical Psychologist	PSY16661	CA

General Provider Information

NPI Number	:	1942415492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STACI R. EMERSON PH.D.

Provider Business Mailing Address
First Line	:	5469 E ANAHEIM RD
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-4324
Country	:	US
Telephone Number	:	310-225-5220
Fax Number	:

Provider Business Practice Location Address
First Line	:	419 N LARCHMONT BLVD # 139
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-3013
Country	:	US
Telephone Number	:	310-225-5220
Fax Number	:

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

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	01/30/2025

Similar Medicare Providers

1649241456 — MR. GAREY RAYMOND P.T
Practice Location Address:

531 N LARCHMONT BLVD , STE# 2
LOS ANGELES, CA
90004-3013

Practice Phone: 323-465-9180
Practice Fax:

1083760995 — DR. RUSSELL J WOJCIK D.P.M.
Practice Location Address:

419 1/2 N LARCHMONT BLVD
LOS ANGELES, CA
90004-3013

Practice Phone: 213-385-1266
Practice Fax:

1942356860 — RUSSELL J. WOJCIK, D.P.M., INC
Practice Location Address:

419 1/2 N LARCHMONT BLVD
LOS ANGELES, CA
90004-3013

Practice Phone: 213-385-1266
Practice Fax:

1689886624 — DR. THOMAS S TANBONLIONG D.D.S.
Practice Location Address:

411 N LARCHMONT BLVD
LOS ANGELES, CA
90004-3013

Practice Phone: 323-304-5763
Practice Fax:

1639360878 — D MICHAEL WEILL DPM - A PROFESSIONAL CORPORATION
Practice Location Address:

419 1/2 N LARCHMONT BLVD
LOS ANGELES, CA
90004-3013

Practice Phone: 323-462-1491
Practice Fax: 323-285-5447

1740412774 — LARSON HEALTH PROVIDERS
Practice Location Address:

419 N LARCHMONT BLVD , STE 78
LOS ANGELES, CA
90004-3013

Practice Phone: 323-307-1552
Practice Fax:

Directions to “ DR. STACI R. EMERSON PH.D.” 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.