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General NPI Number Information
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NPI Number | 1679062608
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Entity Type | Individual
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Provider Name | COURTNEY ANNA SHEETS
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Gender | Female
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Dates
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Enumeration Date | 05/04/2018
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Last Update Date | 05/04/2018
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Provider Practice Location Address
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Address Line | 24328 VERMONT AVE STE 210
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City | HARBOR CITY
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State | CA
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Zip | 90710-2300
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Country | US
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Telephone | 424-269-5842
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Fax |
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Provider Business Mailing Address
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Address Line | 13930 CHADRON AVE APT 314
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City | HAWTHORNE
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State | CA
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Zip | 90250-8288
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Country | US
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Telephone | 661-247-5212
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | AMFT104769
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License Number State | CA
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