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General NPI Number Information
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NPI Number | 1639831894
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Entity Type | Organization
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Legal Business Name | ANNAN COUNSELING CLINIC
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Dates
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Enumeration Date | 10/06/2021
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Last Update Date | 10/06/2021
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Provider Practice Location Address
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Address Line | 4543 COCHRAN ST APT 237
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City | SIMI VALLEY
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State | CA
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Zip | 93063-0306
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Country | US
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Telephone | 818-268-0375
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Fax |
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Provider Business Mailing Address
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Address Line | 4543 COCHRAN ST APT 237
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City | SIMI VALLEY
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State | CA
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Zip | 93063-0306
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Country | US
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Telephone | 818-268-0375
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. BENNETT ANNAN
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Credential | PSYD, EDD
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Telephone | 818-268-0375
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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