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General NPI Number Information
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NPI Number | 1952609703
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Entity Type | Individual
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Provider Name | LORETTA SUN MSW, ACSW
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Gender | Female
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Dates
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Enumeration Date | 03/03/2011
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 901 N. PACIFIC COAST HWY., 200A CONNECTING MENTAL HEALTH & EDUCATION, INC.
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City | REDONDO BEACH
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State | CA
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Zip | 90277
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Country | US
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Telephone | 310-316-1610
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Fax |
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Provider Business Mailing Address
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Address Line | 5215 SEPULVEDA BLVD UNIT 17C
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City | CULVER CITY
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State | CA
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Zip | 90230-5250
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Country | US
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Telephone | 310-880-2986
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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 |
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License Number State |
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