Healthcare Provider Details

I. General information

NPI: 1306444666
Provider Name (Legal Business Name): ANDREW COOPER WASSER MFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2020
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1328 WESTWOOD BLVD SUITE 35
LOS ANGELES CA
90024
US

IV. Provider business mailing address

1328 WESTWOOD BLVD SUITE 35
LOS ANGELES CA
90024
US

V. Phone/Fax

Practice location:
  • Phone: 310-980-2037
  • Fax:
Mailing address:
  • Phone: 310-980-2037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC49315
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: