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NPI 1275188351

NPI 1275188351 : ITZEL M MOLINA MA, MFT : LOS ANGELES, CA

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General NPI Number Information
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    NPI Number           |    1275188351
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    Entity Type          |    Individual 
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    Provider Name        |    ITZEL M MOLINA MA, MFT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/06/2019
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    Last Update Date     |    12/24/2024
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Provider Practice Location Address
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    Address Line         |    2121 W TEMPLE ST 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90026-4915
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    Country              |    US
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    Telephone            |    323-491-4698
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    8500 WILSHIRE BLVD STE 740 
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    City                 |    BEVERLY HILLS
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    State                |    CA
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    Zip                  |    90211-3121
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    Country              |    US
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    Telephone            |    424-832-4692
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    113690
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    License Number State |    CA
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