1174103113 NPI number — WEST COAST PSYCHOLOGICAL THERAPY & COUNSELING INC.

Table of content: MARIA GABRIELA ARANA SAGARDIA M.S., SLP (NPI 1730484288)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174103113 NPI number — WEST COAST PSYCHOLOGICAL THERAPY & COUNSELING INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WEST COAST PSYCHOLOGICAL THERAPY & COUNSELING INC.
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:
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:
1174103113
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/13/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2266 31ST ST APT 17
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA MONICA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90405-2045
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-923-8497
Provider Business Mailing Address Fax Number:
877-217-2340

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3231 OCEAN PARK BLVD STE 218
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA MONICA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90405-3232
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-923-8497
Provider Business Practice Location Address Fax Number:
877-217-2340
Provider Enumeration Date:
04/13/2021

Additional Information

Authorized Official

Authorized Official Last Name:
EPTING
Authorized Official First Name:
MARK
Authorized Official Middle Name:
RICHARD
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
310-923-8497

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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