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General NPI Number Information
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NPI Number | 1770615551
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Entity Type | Individual
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Provider Name | JOSEPH DEGUISA WING MA, LMFT
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Gender | Male
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 01/06/2010
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Provider Practice Location Address
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Address Line | 2620 INDUSTRY WAY
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City | LYNWOOD
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State | CA
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Zip | 90262-4024
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Country | US
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Telephone | 310-631-8004
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Fax |
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Provider Business Mailing Address
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Address Line | 1840 GRIFFITH PARK BLVD APT 2
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City | LOS ANGELES
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State | CA
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Zip | 90026-1046
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Country | US
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Telephone | 323-819-0609
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC #47514
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License Number State | CA
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