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General NPI Number Information
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NPI Number | 1730712761
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Entity Type | Organization
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Legal Business Name | CREATING CHANGE LA, INDIVIDUAL & COUPLE MARRIAGE COUNSELING & SEX THER
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Dates
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Enumeration Date | 02/18/2020
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Last Update Date | 02/18/2020
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Provider Practice Location Address
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Address Line | 337 S BEVERLY DR STE 201
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-4308
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Country | US
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Telephone | 310-963-4216
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Fax |
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Provider Business Mailing Address
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Address Line | 337 S BEVERLY DR STE 201
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-4308
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Country | US
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Telephone | 310-963-4216
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NATALIE FINEGOOD GOLDBERG
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Credential |
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Telephone | 310-963-4216
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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 |
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License Number State |
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