Healthcare Provider Details

I. General information

NPI: 1013255934
Provider Name (Legal Business Name): ABEER A OTHMAN M.A., MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2013
Last Update Date: 01/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15300 VENTURA BLVD STE 324
SHERMAN OAKS CA
91403-5864
US

IV. Provider business mailing address

2633 LINCOLN BLVD # 243
SANTA MONICA CA
90405-4619
US

V. Phone/Fax

Practice location:
  • Phone: 310-633-5093
  • Fax:
Mailing address:
  • Phone: 310-633-5093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 51401
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: