Provider Demographics
NPI:1952445512
Name:WOLKENFELD, MICHAEL Z (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:Z
Last Name:WOLKENFELD
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12647 KILLION ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91607-1534
Mailing Address - Country:US
Mailing Address - Phone:213-308-1701
Mailing Address - Fax:
Practice Address - Street 1:CHILDRENS HOSPITAL LOS ANGELES, 4650 SUNSET BLVD.
Practice Address - Street 2:MAIL STOP #99
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6016
Practice Address - Country:US
Practice Address - Phone:323-361-4641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 20644103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist