Healthcare Provider Details

I. General information

NPI: 1437531274
Provider Name (Legal Business Name): ANNIE FRANCES NARDELLA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2015
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21535 HAWTHORNE BLVD STE 200
TORRANCE CA
90503-6612
US

IV. Provider business mailing address

21535 HAWTHORNE BLVD STE 200
TORRANCE CA
90503-6612
US

V. Phone/Fax

Practice location:
  • Phone: 925-282-1778
  • Fax: 415-296-5299
Mailing address:
  • Phone: 925-282-1778
  • Fax: 415-296-5299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberIMF68438
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT91307
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: