# CAL PSYCH FMT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336345958
- **Authorized official:** MR. MICHAEL C.C. LILIENFELD (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (818) 385-0050

## Contact information

- **Practice address:** 16530 VENTURA BLVD, SUITE 200, ENCINO, CA 91436-4554
- **Practice address phone:** (818) 385-0050
- **Practice address fax:** (818) 385-1166
- **Mailing address:** 16530 VENTURA BLVD, SUITE 200, ENCINO, CA 91436-4554
- **Mailing address phone:** (818) 385-0050
- **Mailing address fax:** (818) 385-1166

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103G00000X | Clinical Neuropsychologist | — | NULL | — |
| 103G00000X | Clinical Neuropsychologist | — | — | — |
| 103TF0200X | Forensic Psychologist | — | NULL | — |
| 103TF0200X | Forensic Psychologist | — | — | — |
| 202C00000X | Independent Medical Examiner Physician | — | NULL | Yes |
| 202C00000X | Independent Medical Examiner Physician | — | — | Yes |
| 2084F0202X | Forensic Psychiatry Physician | — | NULL | — |
| 2084F0202X | Forensic Psychiatry Physician | — | — | — |

## Other

- **Enumeration date:** 06/21/2007
- **Last updated:** 09/11/2025