Healthcare Provider Details

I. General information

NPI: 1831626472
Provider Name (Legal Business Name): MRS. KENDALL BROOKE OBRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KENDALL BROOKE ABRAMOWITZ

II. Dates (important events)

Enumeration Date: 05/14/2017
Last Update Date: 05/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 N EL CENTRO AVE
LOS ANGELES CA
90038-3805
US

IV. Provider business mailing address

815 N EL CENTRO AVE
LOS ANGELES CA
90038-3805
US

V. Phone/Fax

Practice location:
  • Phone: 310-561-2694
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: