Mari Radzik, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY15549 Issued in CA

Practice address

5000 W Sunset Blvd FL 5
Childrens Hospital Los Angeles, Div of Adolescent Med
Los Angeles, CA 90027-5861

Phone

(323) 660-2450

Fax

(323) 913-3614

NPI assigned

Mar 20, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1629193255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 MAVIS DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900655054",
            "telephone_number": "323-342-9080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 W SUNSET BLVD FL 5",
            "address_2": "CHILDRENS HOSPITAL LOS ANGELES, DIV OF ADOLESCENT MED",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275861",
            "telephone_number": "323-660-2450",
            "fax_number": "323-913-3614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADZIK",
        "first_name": "MARI",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY15549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Radnia, M.D.
• Monica Rado, DDS
• Ilana Radparvar
• Lucia Raduca, DDS
• Yasmin Izzah Radzi, DPM
• Bonnie Rae
• Hayede Raeen, LMFT
• Rafael Reisfeld M.D. a Professional Corporation
• Mabel Rafael-Ramos
• Irene Rafael

• Clinical Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.