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General NPI Number Information
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NPI Number | 1710001730
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Entity Type | Individual
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Provider Name | VANESSA KLESERT HURWITZ PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 08/24/2016
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Provider Practice Location Address
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Address Line | 4201 LONG BEACH BLVD SUITE 406
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City | LONG BEACH
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State | CA
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Zip | 90807-2007
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Country | US
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Telephone | 800-624-1475
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 572093
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City | TARZANA
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State | CA
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Zip | 91357-2093
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Country | US
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Telephone | 818-348-1996
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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 | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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