Healthcare Provider Details
I. General information
NPI: 1730203837
Provider Name (Legal Business Name): CHERYL BALDINGER B.A., M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/16/2007
Last Update Date: 05/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1433 S ROBERTSON BLVD
LOS ANGELES CA
90035-3414
US
IV. Provider business mailing address
2828 S BEDFORD ST
LOS ANGELES CA
90034-2523
US
V. Phone/Fax
- Phone: 310-785-2121
- Fax:
- Phone: 310-592-8474
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: