MEDICARE: WILSHIRE COUNSELING CENTER

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
1	305R00000X	Preferred Provider Organization		CA

General Provider Information

NPI Number	:	1851504997
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILSHIRE COUNSELING CENTER

Provider Business Mailing Address
First Line	:	15720 VENTURA BLVD
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91436-2914
Country	:	US
Telephone Number	:	323-651-5828
Fax Number	:

Provider Business Practice Location Address
First Line	:	15720 VENTURA BLVD
Second Line	:	#600
City	:	ENCINO
State	:	CA
Zip	:	91436-2914
Country	:	US
Telephone Number	:	818-906-0406
Fax Number	:	818-906-1566

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. KATRINA WOODS
Credential	:	PHD
Telephone Number	:	323-651-5828

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	07/21/2022

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Directions to “WILSHIRE COUNSELING CENTER ” Practice Location

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