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General NPI Number Information
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NPI Number | 1700036985
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Entity Type | Individual
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Provider Name | VIVIENNE VERDUZCO
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Gender | Female
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Dates
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Enumeration Date | 09/24/2008
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Last Update Date | 04/21/2022
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Provider Practice Location Address
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Address Line | 5100 S EASTERN AVE STE 110
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City | COMMERCE
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State | CA
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Zip | 90040-2964
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Country | US
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Telephone | 844-222-2377
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Fax | 323-837-9719
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Provider Business Mailing Address
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Address Line | 5100 S EASTERN AVE STE 110
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City | COMMERCE
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State | CA
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Zip | 90040-2964
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Country | US
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Telephone | 323-222-2377
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Fax | 323-837-9719
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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 | 132363
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 62584
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License Number State | CA
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