Diversified Psychotherapy Inc | |
5199 E Pacific Coast Hwy Suite 615 Long Beach CA 90804-3302 | |
(562) 743-2789 | |
(562) 743-2789 |
Full Name | Diversified Psychotherapy Inc |
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Speciality | Social Worker - Clinical |
Location | 5199 E Pacific Coast Hwy, Long Beach, California |
Authorized Official Name and Position | Michael Nava (OWNER) |
Authorized Official Contact | 5627432789 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Diversified Psychotherapy Inc Po Box 191 Lakewood CA 90714-0191 Ph: (562) 743-2789 | Diversified Psychotherapy Inc 5199 E Pacific Coast Hwy Suite 615 Long Beach CA 90804-3302 Ph: (562) 743-2789 |
NPI Number | 1215061072 |
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Provider Enumeration Date | 03/15/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215061072 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | LCS 21160 (California) | Primary |
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