Provider Demographics
NPI:1457586224
Name:HEUSCHKEL, SYDELL WEINER (PHD, MFT)
Entity type:Individual
Prefix:DR
First Name:SYDELL
Middle Name:WEINER
Last Name:HEUSCHKEL
Suffix:
Gender:F
Credentials:PHD, MFT
Other - Prefix:DR
Other - First Name:SYDELL
Other - Middle Name:
Other - Last Name:WEINER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:23440 HAWTHORNE BLVD.
Mailing Address - Street 2:SUITE 150
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505
Mailing Address - Country:US
Mailing Address - Phone:310-243-3534
Mailing Address - Fax:
Practice Address - Street 1:23440 HAWTHORNE BLVD.
Practice Address - Street 2:SUITE 150
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505
Practice Address - Country:US
Practice Address - Phone:310-292-2538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-22
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35952106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist