Basic Information
| Provider Information | |||||||||
| NPI: | 1912152885 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ADAM SILBERSTEIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18370 BURBANK BLVD | ||||||||
| Address2: | 311 | ||||||||
| City: | TARZANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913562804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189963200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 18370 BURBANK BLVD | ||||||||
| Address2: | 311 | ||||||||
| City: | TARZANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913562804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189963200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/19/2008 | ||||||||
| LastUpdateDate: | 11/19/2008 | ||||||||
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| AuthorizedOfficialLastName: | SILBERSTEIN | ||||||||
| AuthorizedOfficialFirstName: | ADAM | ||||||||
| AuthorizedOfficialMiddleName: | H | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3107923914 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PSY.D | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | PSY17040 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical |
ID Information
| ID | Type | State | Issuer | Description | PSY17040 | 01 | CA | BOARD OF PSYCHOLOGY | OTHER |