Healthcare Provider Details

I. General information

NPI: 1588742597
Provider Name (Legal Business Name): ANITA CECILE WASHINGTON PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 E COMPTON BLVD
COMPTON CA
90221-3303
US

IV. Provider business mailing address

921 E COMPTON BLVD
COMPTON CA
90221-3303
US

V. Phone/Fax

Practice location:
  • Phone: 310-668-6800
  • Fax: 310-898-3474
Mailing address:
  • Phone: 310-668-6800
  • Fax: 310-898-3474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 8475
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: