Provider Demographics
NPI:1528391521
Name:ANDRICHUK, LYUDMILA (PHD)
Entity Type:Individual
Prefix:
First Name:LYUDMILA
Middle Name:
Last Name:ANDRICHUK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7379 GIBBONS RANCH LN
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-2363
Mailing Address - Country:US
Mailing Address - Phone:916-295-7211
Mailing Address - Fax:
Practice Address - Street 1:7379 GIBBONS RANCH LN
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-2363
Practice Address - Country:US
Practice Address - Phone:916-295-7211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY25719103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic