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General NPI Number Information
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NPI Number | 1558493221
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Entity Type | Individual
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Provider Name | NINOSKA ROSARIO FONSECA MFT
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Gender | Female
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 02/14/2020
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Provider Practice Location Address
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Address Line | 10600 SEPULVEDA BLVD STE 105
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City | MISSION HILLS
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State | CA
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Zip | 91345-1950
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Country | US
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Telephone | 321-821-7959
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Fax | 323-478-8372
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Provider Business Mailing Address
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Address Line | 4625 MARWOOD DR.
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City | LOS ANGELES
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State | CA
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Zip | 90065
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Country | US
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Telephone | 323-478-8372
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Fax | 323-478-8372
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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 | MFC28403
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License Number State | CA
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