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General NPI Number Information
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NPI Number | 1699118646
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Entity Type | Organization
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Legal Business Name | FIG TREE PSYCHOLOGY CENTER
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Dates
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Enumeration Date | 04/09/2013
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Last Update Date | 04/09/2013
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Provider Practice Location Address
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Address Line | 714 W OLYMPIC BLVD STE 704
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City | LOS ANGELES
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State | CA
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Zip | 90015-1439
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Country | US
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Telephone | 310-712-3411
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Fax |
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Provider Business Mailing Address
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Address Line | 714 W OLYMPIC BLVD STE 704
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City | LOS ANGELES
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State | CA
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Zip | 90015-1439
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Country | US
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Telephone | 310-712-3411
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SPENCER FIGUEROA
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Credential |
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Telephone | 310-712-3411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MFT 45991
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License Number State | CA
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