Amick, Leticia C
Amick, Leticia C is an sole proprietor health care provider with primary practice located at 121 W Lexington Dr Suite 346, Glendale CA 91203-2203. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as her primary health care specialty. Amick, Leticia C can be contacted via phone (818) 480-6517.Contact Information
Primary practice address
121 W Lexington Dr Suite 346
Glendale CA 91203-2203
Phone: (818) 480-6517
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | 3497 | Arizona |
Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | PSY 21549 | California |
Profile Details
NPI number | 1063490514 |
---|---|
LBN Legal business name | Amick, Leticia C |
Credentials | PHD |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jan 5th, 2006 |
Last updated | Apr 2nd, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1063490514 | NPPES |
California | Other | GV818Z | MEDICARE PTAN |
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