Healthcare Provider Details

I. General information

NPI: 1043342686
Provider Name (Legal Business Name): MARJATTA VARPU DESCHEPPER MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 SERRANIA AVE
WOODLAND HILLS CA
91364-3301
US

IV. Provider business mailing address

29621 WINDSONG LN
AGOURA HILLS CA
91301-4058
US

V. Phone/Fax

Practice location:
  • Phone: 818-657-3136
  • Fax: 818-347-0184
Mailing address:
  • Phone: 818-889-1831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMCF29943
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: