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General NPI Number Information
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NPI Number | 1912525056
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Entity Type | Individual
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Provider Name | WALTER HIRSCH LMFT
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Gender | Male
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Dates
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Enumeration Date | 07/06/2020
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Last Update Date | 07/06/2020
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Provider Practice Location Address
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Address Line | 11835 W OLYMPIC BLVD STE 405
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City | LOS ANGELES
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State | CA
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Zip | 90064-5002
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Country | US
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Telephone | 424-322-9929
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3323
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City | SANTA MONICA
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State | CA
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Zip | 90408-3323
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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 |
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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 | 119788
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License Number State | CA
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