Healthcare Provider Details

I. General information

NPI: 1528250636
Provider Name (Legal Business Name): PAIGE G PARKER MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3303 N BROADWAY
LOS ANGELES CA
90031-2803
US

IV. Provider business mailing address

200 E MAPLE AVE
EL SEGUNDO CA
90245-2330
US

V. Phone/Fax

Practice location:
  • Phone: 323-478-8200
  • Fax:
Mailing address:
  • Phone: 310-251-4170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number49375
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: