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General NPI Number Information
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NPI Number | 1588333009
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Entity Type | Organization
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Legal Business Name | AMLA FAMILY COUNSELING INC.
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Dates
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Enumeration Date | 09/08/2021
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 2001 WILSHIRE BLVD STE 302
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City | SANTA MONICA
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State | CA
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Zip | 90403-5685
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Country | US
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Telephone | 949-610-2978
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Fax |
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Provider Business Mailing Address
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Address Line | 2900 BRISTOL ST STE B320
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City | COSTA MESA
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State | CA
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Zip | 92626-5987
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Country | US
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Telephone | 949-610-2978
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JASON BRUMBACK
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Credential | MFT
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Telephone | 509-319-0845
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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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