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General NPI Number Information
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NPI Number | 1316683741
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Entity Type | Organization
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Legal Business Name | AB FAMILY THERAPIST PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 05/09/2022
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Last Update Date | 08/31/2024
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Provider Practice Location Address
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Address Line | 2530 WILSHIRE BLVD STE 300
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City | SANTA MONICA
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State | CA
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Zip | 90403-4659
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Country | US
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Telephone | 310-402-0005
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Fax | 310-987-4655
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Provider Business Mailing Address
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Address Line | 2530 WILSHIRE BLVD STE 300
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City | SANTA MONICA
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State | CA
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Zip | 90403-4659
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Country | US
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Telephone | 310-402-0005
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Fax | 310-987-4655
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Authorized Official
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Title or Position | PROVIDER
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Name | AMADA BATTISTA
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Credential | LMFT
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Telephone | 310-402-0005
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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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