Provider Demographics
NPI:1699834192
Name:STRICKLAND, ANTHONY L (PHD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:L
Last Name:STRICKLAND
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:TONY
Other - Middle Name:L
Other - Last Name:STRICKLAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:6101 W CENTINELA AVENUE
Mailing Address - Street 2:SUITE 211
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230
Mailing Address - Country:US
Mailing Address - Phone:310-642-9595
Mailing Address - Fax:310-642-9590
Practice Address - Street 1:6101 W CENTINELA AVE
Practice Address - Street 2:SUITE 211
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6337
Practice Address - Country:US
Practice Address - Phone:310-642-9595
Practice Address - Fax:310-642-9590
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12223103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY12223OtherSTATE LICENSE NUMBER
CAPSY12223OtherBLUE SHIELD
CAWCP12223AMedicare PIN