1710420385 NPI number — THE ENCOUNTER GROUP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710420385 NPI number — THE ENCOUNTER GROUP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE ENCOUNTER GROUP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710420385
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/29/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
120 E CHEVY CHASE DR UNIT 251552
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLENDALE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91225-8078
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-717-4160
Provider Business Mailing Address Fax Number:
818-275-3654

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2626 FOOTHILL BLVD STE 203
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LA CRESCENTA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91214-3574
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-717-4160
Provider Business Practice Location Address Fax Number:
818-275-3654
Provider Enumeration Date:
11/29/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MALINOWSKA
Authorized Official First Name:
PATRYCJA
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER OF PRACTICE
Authorized Official Telephone Number:
323-717-4160

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LCSW29507 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)