Provider Demographics
NPI:1558504910
Name:FALK, CECILE M (PHD)
Entity Type:Individual
Prefix:
First Name:CECILE
Middle Name:M
Last Name:FALK
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 1:4646 CONCHITA WAY
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4906
Mailing Address - Country:US
Mailing Address - Phone:323-464-1930
Mailing Address - Fax:818-345-7793
Practice Address - Street 1:321 N LARCHMONT BLVD
Practice Address - Street 2:SUITE 814
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-3025
Practice Address - Country:US
Practice Address - Phone:323-464-1930
Practice Address - Fax:818-345-7793
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY4793103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP4793Medicare UPIN
CACP4793AMedicare UPIN