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General NPI Number Information
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NPI Number | 1912951732
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Entity Type | Organization
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Legal Business Name | SPECIAL SERVICE FOR GROUPS, INC.
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 11/10/2021
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Provider Practice Location Address
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Address Line | 520 S LA FAYETTE PARK PL #300
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City | LOS ANGELES
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State | CA
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Zip | 90057-5400
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Country | US
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Telephone | 213-252-2100
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Fax | 213-383-3146
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Provider Business Mailing Address
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Address Line | 905 E 8TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90021-1848
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Country | US
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Telephone | 213-553-1800
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Fax | 213-553-1822
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. HERBERT K. HATANAKA
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Credential |
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Telephone | 213-553-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | CA
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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 |
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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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 | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State | CA
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Taxonomy #8
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State | CA
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