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General NPI Number Information
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NPI Number | 1144376344
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Entity Type | Organization
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Legal Business Name | CUNNINGHAM PSYCHIATRIC GROUP
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Dates
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Enumeration Date | 01/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4419 VAN NUYS BLVD #407
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-2910
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Country | US
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Telephone | 818-759-3477
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Fax |
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Provider Business Mailing Address
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Address Line | 4419 VAN NUYS BLVD #407
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-2910
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Country | US
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Telephone | 818-759-3477
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAREN CUNNINGHAM
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Credential | M.D.
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Telephone | 818-759-3477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | G074783
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License Number State | CA
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