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General NPI Number Information
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NPI Number | 1366082844
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Entity Type | Organization
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Legal Business Name | CALIFORNIA INSTITUTE OF HEALTH & SOCIAL SERVICES
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Dates
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Enumeration Date | 01/13/2020
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 3756 SANTA ROSALIA DR STE 628
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City | LOS ANGELES
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State | CA
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Zip | 90008-3606
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Country | US
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Telephone | 323-293-8771
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Fax |
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Provider Business Mailing Address
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Address Line | 8939 S SEPULVEDA BLVD STE 401
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City | LOS ANGELES
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State | CA
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Zip | 90045-3646
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Country | US
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Telephone | 310-645-5227
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Fax | 310-645-9840
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MS. CYNTHIA MARSHALL
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Credential |
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Telephone | 310-645-5227
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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