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General NPI Number Information
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NPI Number | 1669100301
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Entity Type | Organization
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Legal Business Name | E.L. FOROUTAN MARRIAGE AND FAMILY THERAPY INC.
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Dates
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Enumeration Date | 08/10/2022
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Last Update Date | 08/10/2022
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Provider Practice Location Address
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Address Line | 2656 29TH ST STE 208
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City | SANTA MONICA
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State | CA
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Zip | 90405-2947
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Country | US
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Telephone | 213-538-2790
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Fax |
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Provider Business Mailing Address
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Address Line | 6121 1/2 GLEN HOLLY ST
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City | LOS ANGELES
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State | CA
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Zip | 90068-2301
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Country | US
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Telephone | 562-619-2400
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | ERIKA LAUREN FOROUTAN
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Credential | LMFT
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Telephone | 213-538-2790
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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 |
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License Number State |
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