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General NPI Number Information
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NPI Number | 1801415823
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Entity Type | Organization
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Legal Business Name | ABIGAIL GOLD, LLC
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Dates
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Enumeration Date | 04/09/2020
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Last Update Date | 04/09/2020
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Provider Practice Location Address
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Address Line | 2730 WILSHIRE BLVD STE 250
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City | SANTA MONICA
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State | CA
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Zip | 90403-4749
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Country | US
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Telephone | 818-398-1478
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Fax |
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Provider Business Mailing Address
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Address Line | 2730 WILSHIRE BLVD STE 250
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City | SANTA MONICA
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State | CA
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Zip | 90403-4749
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. ABIGAIL GOLD
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Credential | M.A., LMFT
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Telephone | 818-398-1478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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