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Organization
THE REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Organization
THE REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Parent organization
UCLA - VINE STREET CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
UCLA - VINE STREET CLINIC
Authorized official
PROF. STEVEN JOSEPH SHOPTAW PHD (PROF PSYCHIATRY AND BEHAVIORAL SCIE)
(310) 794-6206
Entity
Organization
Contact information
Practice address
910 VINE STREET, LOS ANGELES, CA 90038-2702
(323) 461-3106
(323) 461-3109
Mailing address
910 VINE STREET, LOS ANGELES, CA 90038-2702
(323) 461-3106
(323) 461-3109
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PFY13300
CA
Other
Enumeration date
09/01/2010
Last updated
09/01/2010
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