Provider Demographics
NPI:1396003679
Name:SHUMAN, RICK (RICK SHUMAN,PHD)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:
Last Name:SHUMAN
Suffix:
Gender:M
Credentials:RICK SHUMAN,PHD
Other - Prefix:
Other - First Name:RICK
Other - Middle Name:
Other - Last Name:SHUMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RICK SHUMAN,PHD
Mailing Address - Street 1:1554 S SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-3377
Mailing Address - Country:US
Mailing Address - Phone:310-477-9700
Mailing Address - Fax:
Practice Address - Street 1:1554 S SEPULVEDA BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-3377
Practice Address - Country:US
Practice Address - Phone:310-477-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 9529101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health