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General NPI Number Information
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NPI Number | 1366627812
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Entity Type | Individual
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Provider Name | AMY A ALLEN
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Gender | Female
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Dates
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Enumeration Date | 01/03/2008
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Last Update Date | 03/10/2021
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Provider Practice Location Address
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Address Line | 2311 W EL SEGUNDO BLVD
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City | HAWTHORNE
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State | CA
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Zip | 90250-3315
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Country | US
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Telephone | 323-241-6730
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Fax | 323-242-1935
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Provider Business Mailing Address
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Address Line | 550 S VERMONT AVE 3RD FLOOR HEADQUARTERS
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City | LOS ANGELES
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State | CA
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Zip | 90020-1912
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Country | US
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Telephone | 213-974-0596
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Fax | 213-620-1405
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 87661
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License Number State | CA
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