Healthcare Provider Details

I. General information

NPI: 1922489798
Provider Name (Legal Business Name): FOCUS ON ALL-CHILD THERAPIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2015
Last Update Date: 06/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10642 SANTA MONICA BLVD #201
LOS ANGELES CA
90025-4525
US

IV. Provider business mailing address

10642 SANTA MONICA BLVD #201
LOS ANGELES CA
90025-4525
US

V. Phone/Fax

Practice location:
  • Phone: 310-475-9620
  • Fax: 310-470-3169
Mailing address:
  • Phone: 310-475-9620
  • Fax: 310-470-3169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: LINDA ANDRON OSTROW
Title or Position: EXECUTIVE DIRECTOR
Credential: LCSW
Phone: 310-475-9620