Healthcare Provider Details

I. General information

NPI: 1003710575
Provider Name (Legal Business Name): DANIEL RODOLFO FALAGAN AMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RUDY FALAGAN AMFT

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4221 WILSHIRE BLVD STE 230
LOS ANGELES CA
90010-3554
US

IV. Provider business mailing address

6771 WARNER AVE PO BOX 1561
HUNTINGTON BEACH CA
92647-9400
US

V. Phone/Fax

Practice location:
  • Phone: 213-441-6780
  • Fax:
Mailing address:
  • Phone: 213-441-6780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number164499
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: