| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| 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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