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NPI Code Detail

MEDICARE: DAVIDSON MARRIAGE AND FAMILY THERAPY GROUP INC

MEDICARE: DAVIDSON MARRIAGE AND FAMILY THERAPY GROUP INC
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
11041C0700XClinical Social Worker
2106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1780528414
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAVIDSON MARRIAGE AND FAMILY THERAPY GROUP INC
Provider Business Mailing Address
First Line : 1849 SAWTELLE BLVD STE 610
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-7013
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1849 SAWTELLE BLVD STE 610
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-7013
Country : US
Telephone Number : 424-248-8403
Fax Number :
Authorized Official
Title or Position : OWNER
Name : REBEKA DAVIDSON
Credential : LMFT
Telephone Number : 831-905-3626
Provider Enumeration Date : 04/15/2026
Last Update Date : 04/15/2026

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Directions to “DAVIDSON MARRIAGE AND FAMILY THERAPY GROUP INC ” Practice Location

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