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General NPI Number Information
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NPI Number | 1942916333
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Entity Type | Organization
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Legal Business Name | PROGRAM FOR TORTURE VICTIMS
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Dates
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Enumeration Date | 01/27/2023
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 800 W 6TH ST STE 450
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City | LOS ANGELES
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State | CA
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Zip | 90017-2708
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Country | US
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Telephone | 213-384-4788
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Fax |
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Provider Business Mailing Address
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Address Line | 800 W 6TH ST STE 450
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City | LOS ANGELES
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State | CA
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Zip | 90017-2708
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Country | US
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Telephone | 213-384-4788
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ANA GRANDE
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Credential |
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Telephone | 213-384-4788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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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 |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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