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General NPI Number Information
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NPI Number | 1104417617
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Entity Type | Organization
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Legal Business Name | AVANZA FAMILY SERVICES INCORPORATED
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Dates
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Enumeration Date | 01/27/2021
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 4325 W SUNSET BLVD STE 209
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City | LOS ANGELES
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State | CA
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Zip | 90029-2180
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Country | US
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Telephone | 310-878-2599
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Fax | 323-798-4416
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Provider Business Mailing Address
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Address Line | 6510 LA MIRADA AVE APT 305
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City | LOS ANGELES
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State | CA
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Zip | 90038-1465
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Country | US
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Telephone | 310-346-1019
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Fax | 323-798-4416
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. CESAR JASS
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Credential | LMFT
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Telephone | 310-346-1019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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