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General NPI Number Information
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NPI Number | 1043625536
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Entity Type | Organization
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Legal Business Name | THE CAMDEN CENTER
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Dates
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Enumeration Date | 06/24/2014
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Last Update Date | 06/24/2014
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Provider Practice Location Address
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Address Line | 10780 SANTA MONICA BLVD SUITE 105
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City | LOS ANGELES
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State | CA
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Zip | 90025-4749
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Country | US
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Telephone | 310-741-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 10780 SANTA MONICA BLVD SUITE 105
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City | LOS ANGELES
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State | CA
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Zip | 90025-4749
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Country | US
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Telephone | 310-741-2000
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MR. ARIE MATTHEW WINOGRAD
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Credential | LMFT
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Telephone | 310-741-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | MFT39567
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License Number State | CA
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