=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942072079
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INDIVIDUAL AND FAMILY FOCUS THERAPY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/23/2023
-----------------------------------------------------
Last Update Date | 10/23/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14623 HAWTHORNE BLVD STE 309
-----------------------------------------------------
City | LAWNDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90260-1590
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-531-3258
-----------------------------------------------------
Fax | 424-263-2868
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14623 HAWTHORNE BLVD STE 309
-----------------------------------------------------
City | LAWNDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90260-1590
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-531-3258
-----------------------------------------------------
Fax | 424-263-2868
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MRS. GUADALUPE H CABRAL
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 310-531-3258
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------