Healthcare Provider Details

I. General information

NPI: 1013839810
Provider Name (Legal Business Name): CODI GEORGES AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 S BARRINGTON AVE STE 302
LOS ANGELES CA
90025-5379
US

IV. Provider business mailing address

PO BOX 49811
LOS ANGELES CA
90049-0811
US

V. Phone/Fax

Practice location:
  • Phone: 213-584-3574
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number163330
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: