=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992944730
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CYNTHIA LEE RICH MS, MFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/18/2009
-----------------------------------------------------
Last Update Date | 02/18/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4305 TORRANCE BLVD SUITE 300
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90503-4409
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-989-8583
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 983 LA CRESTA PL
-----------------------------------------------------
City | PALOS VERDES ESTATES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90274-2051
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-375-8806
-----------------------------------------------------
Fax | 310-378-4218
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 46871
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------