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General NPI Number Information
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NPI Number | 1801027560
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Entity Type | Individual
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Provider Name | DANIEL RAVANSHENAS LMFT
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Gender | Male
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Dates
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Enumeration Date | 07/29/2009
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 2405 CLOY AVE
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City | VENICE
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State | CA
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Zip | 90291-4752
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Country | US
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Telephone | 310-980-2827
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Fax |
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Provider Business Mailing Address
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Address Line | 1240 S SHERBOURNE DR PH 1
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City | LOS ANGELES
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State | CA
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Zip | 90035-2369
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Country | US
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Telephone | 310-980-2827
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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 | 53957
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License Number State |
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