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General NPI Number Information
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NPI Number | 1790161180
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Entity Type | Individual
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Provider Name | MICHELLE DEAN
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Gender | Female
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Dates
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Enumeration Date | 08/07/2015
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 10277 W OLYMPIC BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90067-7005
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Country | US
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Telephone | 243-622-9314
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Fax |
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Provider Business Mailing Address
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Address Line | JOHN WOODEN CENTER WEST 221 WESTWOOD PLAZA
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City | LOS ANGELES
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State | CA
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Zip | 90095-1556
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Country | US
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Telephone | 310-825-0768
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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 | AMFT96892
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT109575
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License Number State | CA
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Taxonomy #4
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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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Taxonomy #5
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMF96892
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License Number State | CA
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