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General NPI Number Information
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NPI Number | 1710174149
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Entity Type | Organization
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Legal Business Name | DIDI HIRSCH
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 10/01/2007
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Provider Practice Location Address
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Address Line | 12420 VENICE BLVD 200
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City | LOS ANGELES
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State | CA
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Zip | 90066-3840
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Country | US
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Telephone | 310-751-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 4760 SEPULVEDA BLVD
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City | CULVER CITY
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State | CA
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Zip | 90230-4820
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Country | US
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Telephone | 310-157-5437
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Fax |
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Authorized Official
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Title or Position | BILINGUAL THERAPIST I
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Name | JENNY YVETTE RAMIREZ
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Credential | MFTI
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Telephone | 310-751-5437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 54436
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License Number State | CA
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