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General NPI Number Information
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NPI Number | 1639580285
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Entity Type | Individual
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Provider Name | MICHELLE GRUNSTEIN LMFT99291
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Gender | Female
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Dates
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Enumeration Date | 05/16/2014
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Last Update Date | 07/02/2020
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Provider Practice Location Address
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Address Line | 16200 VENTURA BLVD STE 406
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City | ENCINO
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State | CA
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Zip | 91436-4695
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Country | US
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Telephone | 323-559-2726
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Fax |
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Provider Business Mailing Address
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Address Line | 16200 VENTURA BLVD STE 406
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City | ENCINO
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State | CA
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Zip | 91436-4695
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Country | US
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Telephone | 323-559-2726
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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 | 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 | 99291
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License Number State | CA
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