Provider Demographics
NPI:1285843706
Name:HULNICK, RONALD (PHD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:
Last Name:HULNICK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21130 BELLINI DR
Mailing Address - Street 2:
Mailing Address - City:TOPANGA
Mailing Address - State:CA
Mailing Address - Zip Code:90290-4408
Mailing Address - Country:US
Mailing Address - Phone:818-999-1589
Mailing Address - Fax:818-999-1418
Practice Address - Street 1:2107 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5735
Practice Address - Country:US
Practice Address - Phone:310-829-7402
Practice Address - Fax:310-453-5641
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMS 16357106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist