Silver Lake Psychology Inc.

Organization Active NPI Psychologist · Los Angeles, CA

NPI 1932651817 · NPPES record last updated Oct 4, 2022

Key facts

NPI
1932651817
Entity type
Organization (NPI type 2)
Primary specialty
Psychologist 103T00000X
License
22512 (CA)
Legal business name
SILVER LAKE PSYCHOLOGY INC.
Practice address
4325 W Sunset Blvd
206
Los Angeles, CA 90029-2174
Phone
(310) 388-7983
NPI assigned
Oct 26, 2016
Organization subpart
No

Authorized official

Name
Brandy Dunn, PSYD
Title
Ceo
Phone
(310) 388-7983

Practitioners 142

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 142

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in CA, VA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20190524000695 CA Part B Supplier - Clinic/Group Practice 7012250582 Receives reassigned benefits from 105 practitioners
Practice locations: Los Angeles, CA
O20251025000289 VA Part B Supplier - Clinic/Group Practice 7012250582 Receives reassigned benefits from 1 practitioner
Practice locations: Virginia Beach, VA

National Provider Directory

Locations

2301 Hyperion Ave
Los Angeles, CA 90027
Phone (310) 388-7983

2301 Hyperion Ave
#A
Los Angeles, CA 90027
Phone (310) 726-3890

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP
103T00000X 22512 CA Yes

Addresses

Primary practice location

4325 W Sunset Blvd
206
Los Angeles, CA 90029-2174

Mailing address

4325 W Sunset Blvd
206
Los Angeles, CA 90029-2174
Phone (310) 388-7983

Other providers in Los Angeles, CA

All providers in Los Angeles, CA · Psychologist in California

Sources for this page

Verify at the official NPI Registry.