Organization
UC REGENTS
Active
Other names
UCLA Neuropsychiatric Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J GITLIN MD (PROF OF CLIN PSY CHAIR & DIRECTOR)
(310) 825-9989
Entity
Organization
Contact information
Practice address
300 MEDICAL PLAZA, LOS ANGELES, CA 90095
(310) 825-9989
Mailing address
FILE 2939, LOS ANGELES, CA 90074
(310) 825-9989
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
Primary
—
CA
103TC0700X
Clinical Psychologist
—
CA
103TC2200X
Clinical Child & Adolescent Psychologist
—
CA
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
2084P0805X
Geriatric Psychiatry Physician
—
—
235Z00000X
Speech-Language Pathologist
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GPS000090
—
CA
05
—
GR0053840
—
CA
05
—
GSP000650
—
CA
Enumeration date
12/29/2005
Last updated
08/31/2022
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