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NPI Code Detail

MEDICARE: MS. GWENNITA WATSON

MEDICARE:  MS. GWENNITA  WATSON
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 Therapist146270CA

General Provider Information

NPI Number : 1437277175
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GWENNITA WATSON
Provider Business Mailing Address
First Line : 2116 ARLINGTON AVE STE 100
Second Line :
City : LOS ANGELES
State : CA
Zip : 90018-1300
Country : US
Telephone Number : 323-334-9000
Fax Number :
Provider Business Practice Location Address
First Line : 2116 ARLINGTON AVE STE 100
Second Line :
City : LOS ANGELES
State : CA
Zip : 90018-1300
Country : US
Telephone Number : 323-334-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2007
Last Update Date : 04/26/2024

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Directions to “ MS. GWENNITA WATSON ” Practice Location

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