MEDICARE: DORIS WOLZ-COHEN MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	31676	CA

General Provider Information

NPI Number	:	1518376839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DORIS WOLZ-COHEN MFT

Provider Business Mailing Address
First Line	:	3101 OCEAN PARK BLVD STE 304
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90405-3022
Country	:	US
Telephone Number	:	310-721-7201
Fax Number	:

Provider Business Practice Location Address
First Line	:	3101 OCEAN PARK BLVD STE 304
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90405-3022
Country	:	US
Telephone Number	:	310-721-7201
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2014
Last Update Date	:	10/29/2023

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