Healthcare Provider Details

I. General information

NPI: 1902466782
Provider Name (Legal Business Name): ZATORI INDIVIDUAL, MARRIAGE AND FAMILY THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2019
Last Update Date: 01/18/2020
Certification Date: 01/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 WILSHIRE BLVD STE 650
SANTA MONICA CA
90403-4746
US

IV. Provider business mailing address

1515 7TH ST # 278
SANTA MONICA CA
90401-2605
US

V. Phone/Fax

Practice location:
  • Phone: 310-980-6306
  • Fax:
Mailing address:
  • Phone: 310-980-6306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ISOBEL GARDNER
Title or Position: PRESIDENT
Credential: LMFT
Phone: 310-980-6306