Healthcare Provider Details

I. General information

NPI: 1427216621
Provider Name (Legal Business Name): JOSEPHINA OLARITA DHUNGANA MFC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. JOSEFINA OLARITA DHUNGANA

II. Dates (important events)

Enumeration Date: 05/26/2008
Last Update Date: 05/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 PALOS VERDES BLVD SUITE B
REDONDO BEACH CA
90277-5800
US

IV. Provider business mailing address

2070 261ST ST
LOMITA CA
90717-3216
US

V. Phone/Fax

Practice location:
  • Phone: 310-374-7407
  • Fax: 310-318-6626
Mailing address:
  • Phone: 310-530-4167
  • Fax: 310-513-6766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 45422
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: