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NPI 1821454240

NPI 1821454240 : AMADA BATTISTA B.A.,IMFT : SANTA MONICA, CA

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General NPI Number Information
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    NPI Number           |    1821454240
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    Entity Type          |    Individual 
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    Provider Name        |    AMADA BATTISTA B.A.,IMFT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/14/2016
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    Last Update Date     |    08/31/2024
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Provider Practice Location Address
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    Address Line         |    2530 WILSHIRE BLVD STE 300 
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    City                 |    SANTA MONICA
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    State                |    CA
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    Zip                  |    90403-4659
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    Country              |    US
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    Telephone            |    310-402-0005
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    Fax                  |    310-987-4655
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Provider Business Mailing Address
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    Address Line         |    2530 WILSHIRE BLVD STE 300 
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    City                 |    SANTA MONICA
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    State                |    CA
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    Zip                  |    90403-4659
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    Country              |    US
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    Telephone            |    310-402-0005
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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       |    102607
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    License Number State |    CA
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