Individual
AMANDA GULSRUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
760 WESTWOOD PLZ, RM 68-237C, LOS ANGELES, CA 90024-5055
(310) 825-0575
Mailing address
760 WESTWOOD PLZ, RM 68-237C, LOS ANGELES, CA 90024-5055
(310) 825-0575
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
24771
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083960413
—
CA
Enumeration date
08/03/2012
Last updated
11/13/2012
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