Provider Demographics
NPI:1093848871
Name:SKLANSKY, BERTA (MSW LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BERTA
Middle Name:
Last Name:SKLANSKY
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:BERTA
Other - Middle Name:
Other - Last Name:RISKINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5001 SHOWBOAT PLACE
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-4468
Mailing Address - Country:US
Mailing Address - Phone:310-558-3044
Mailing Address - Fax:310-558-3044
Practice Address - Street 1:5001 SHOWBOAT PLACE
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-4468
Practice Address - Country:US
Practice Address - Phone:310-558-3044
Practice Address - Fax:310-558-3044
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS12855103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
S02279Medicare UPIN
CASW12855AMedicare ID - Type Unspecified