Healthcare Provider Details

I. General information

NPI: 1639212665
Provider Name (Legal Business Name): JOSEPH FRANCIS HERZBERG MFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 08/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1540 E COLORADO ST
GLENDALE CA
91205-1514
US

IV. Provider business mailing address

495 TAMARAC DR
PASADENA CA
91105-2198
US

V. Phone/Fax

Practice location:
  • Phone: 818-244-7257
  • Fax: 818-243-5413
Mailing address:
  • Phone: 626-379-9311
  • Fax: 818-243-5413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: