Provider Demographics
NPI:1073327573
Name:CICOLLI, VIKTORIA (PSYD)
Entity type:Individual
Prefix:DR
First Name:VIKTORIA
Middle Name:
Last Name:CICOLLI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 WILSHIRE BLVD # 740
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3121
Mailing Address - Country:US
Mailing Address - Phone:213-539-8973
Mailing Address - Fax:
Practice Address - Street 1:8500 WILSHIRE BLVD # 740
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3121
Practice Address - Country:US
Practice Address - Phone:213-539-8973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY35554103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty