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General NPI Number Information
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NPI Number | 1770619819
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Entity Type | Individual
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Provider Name | ALISE YVETTE SOCHACZEWSKI M.F.T.
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Gender | Female
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Dates
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Enumeration Date | 02/25/2007
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Last Update Date | 07/19/2007
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Provider Practice Location Address
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Address Line | 914 S ROBERTSON BLVD SUITE 105
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City | LOS ANGELES
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State | CA
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Zip | 90035-1639
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Country | US
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Telephone | 310-717-4924
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Fax |
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Provider Business Mailing Address
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Address Line | 5482 WILSHIRE BLVD #317
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City | LOS ANGELES
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State | CA
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Zip | 90036-4218
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Country | US
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Telephone | 310-717-4924
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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 39873
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License Number State | CA
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