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NPI Code Detail

MEDICARE: ILENE VAL-ESSEN MFT PHD

MEDICARE:   ILENE  VAL-ESSEN  MFT PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistMFT6843CA

General Provider Information

NPI Number : 1093826273
Entity Type Code : Individual
Provider Name (Legal Business Name) : ILENE VAL-ESSEN MFT PHD
Provider Business Mailing Address
First Line : 4909 ST LOUIS COURT
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-4317
Country : US
Telephone Number : 310-839-1571
Fax Number : 310-839-1614
Provider Business Practice Location Address
First Line : 4909 ST LOUIS COURT
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-4317
Country : US
Telephone Number : 310-839-1571
Fax Number : 310-839-1614
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/08/2007

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Directions to “ ILENE VAL-ESSEN MFT PHD” Practice Location

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