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General NPI Number Information
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NPI Number | 1376255992
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Entity Type | Individual
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Provider Name | ALYSHIA MARCELLETTI AMFT. APCC, NDTR
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Gender | Female
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Dates
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Enumeration Date | 12/14/2022
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 17609 VENTURA BLVD STE 302
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City | ENCINO
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State | CA
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Zip | 91316-5128
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Country | US
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Telephone | 310-494-6241
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Fax |
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Provider Business Mailing Address
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Address Line | 2717 S ROBERTSON BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90034-2442
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Country | US
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Telephone | 323-334-0937
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | R1491751222
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License Number State | CA
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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 | 147455
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License Number State | CA
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