| Cogdiversified | |
|
2022 Vancouver Ave # A Monterey Park CA 91754-5908 | |
| (571) 376-8348 | |
| Not Available |
| Full Name | Cogdiversified |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 2022 Vancouver Ave # A, Monterey Park, California |
| Authorized Official Name and Position | Tianjiao Sun (DIRECTOR) |
| Authorized Official Contact | 5713768348 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cogdiversified 2022 Vancouver Ave # A Monterey Park CA 91754-5908 Ph: (571) 376-8348 | Cogdiversified 2022 Vancouver Ave # A Monterey Park CA 91754-5908 Ph: (571) 376-8348 |
| NPI Number | 1962221119 |
|---|---|
| Provider Enumeration Date | 10/05/2024 |
| Last Update Date | 10/05/2024 |
| Certification Date | 10/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962221119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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