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General NPI Number Information
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NPI Number | 1689012379
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Entity Type | Organization
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Legal Business Name | BOBBI EBSEN PSYCHOTHERAPY LLC
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Dates
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Enumeration Date | 06/05/2013
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 453 S SPRING ST STE 400
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City | LOS ANGELES
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State | CA
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Zip | 90013-2074
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Country | US
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Telephone | 510-391-4099
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Fax |
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Provider Business Mailing Address
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Address Line | 453 S SPRING ST STE 400
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City | LOS ANGELES
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State | CA
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Zip | 90013-2074
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Country | US
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Telephone | 510-391-4099
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | KRISTI EBSEN
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Credential | LMSW, LCSW
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Telephone | 510-391-4099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801085914
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License Number State | MI
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