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NPI 1194588848

NPI 1194588848 : ALEX PRIMO MARRIAGE & FAMILY THERAPY, INC., PC : CHATSWORTH, CA

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General NPI Number Information
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    NPI Number           |    1194588848
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    Entity Type          |    Organization 
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    Legal Business Name  |    ALEX PRIMO MARRIAGE & FAMILY THERAPY, INC., PC 
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Dates
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    Enumeration Date     |    02/05/2024
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    Last Update Date     |    02/05/2024
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Provider Practice Location Address
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    Address Line         |    20121 DEVONSHIRE ST 
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    City                 |    CHATSWORTH
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    State                |    CA
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    Zip                  |    91311-3408
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    Country              |    US
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    Telephone            |    818-875-9017
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    18017 CHATSWORTH ST STE 166 
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    City                 |    GRANADA HILLS
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    State                |    CA
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    Zip                  |    91344-5608
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    Country              |    US
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    Telephone            |    818-875-9017
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    Fax                  |    
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Authorized Official
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    Title or Position    |    MARRIAGE & FAMILY THERAPIST
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    Name                 |     ALEX  PRIMO 
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    Credential           |    LMFT
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    Telephone            |    818-875-9017
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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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