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General NPI Number Information
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NPI Number | 1922346683
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Entity Type | Individual
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Provider Name | JOHN ADAM MUNTNER MFT
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Gender | Male
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Dates
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Enumeration Date | 01/30/2013
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Last Update Date | 01/30/2013
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Provider Practice Location Address
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Address Line | 2901 OCEAN PARK BLVD #126
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City | SANTA MONICA
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State | CA
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Zip | 90405-2919
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Country | US
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Telephone | 310-399-4043
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Fax |
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Provider Business Mailing Address
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Address Line | 10736 JEFFERSON BLVD #878
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City | CULVER CITY
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State | CA
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Zip | 90230-4933
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Country | US
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Telephone | 323-459-2383
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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 | 52793
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License Number State | CA
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