MEDICARE: HAMBURGER HOME

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1972932531
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAMBURGER HOME

Provider Business Mailing Address
First Line	:	3580 WILSHIRE BLVD
Second Line	:	STE 800
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-2501
Country	:	US
Telephone Number	:	213-637-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1530 ORANGE DRIVE
Second Line	:	ROOM 101-W
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-7001
Country	:	US
Telephone Number	:	213-637-5000
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICE
Name	:	MRS. AMBER RIVAS
Credential	:	LMFT
Telephone Number	:	323-876-0550

Provider Enumeration Date	:	11/04/2013
Last Update Date	:	03/14/2023

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Directions to “HAMBURGER HOME ” Practice Location

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