Provider Demographics
NPI:1134277239
Name:FRCEK, LORENA (PHD)
Entity type:Individual
Prefix:DR
First Name:LORENA
Middle Name:
Last Name:FRCEK
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 1:961 AMHERST AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-5801
Mailing Address - Country:US
Mailing Address - Phone:310-442-2630
Mailing Address - Fax:310-442-2859
Practice Address - Street 1:11303 W WASHINGTON BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-6003
Practice Address - Country:US
Practice Address - Phone:310-482-6658
Practice Address - Fax:310-313-0973
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist