Provider Demographics
NPI:1477753556
Name:UCLA
Entity Type:Organization
Organization Name:UCLA
Other - Org Name:SEMEL INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RESIDENCY COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-825-0018
Mailing Address - Street 1:760 WESTWOOD PLZ
Mailing Address - Street 2:SUITE C8-222
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-5055
Mailing Address - Country:US
Mailing Address - Phone:310-825-0018
Mailing Address - Fax:
Practice Address - Street 1:760 WESTWOOD PLZ
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-5055
Practice Address - Country:US
Practice Address - Phone:310-825-0018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99803261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health