Provider First Line Business Practice Location Address:
6651 BALBOA BLVD
Provider Second Line Business Practice Location Address:
LAUSD/SCHOOL MENTAL HEALTH
Provider Business Practice Location Address City Name:
VAN NUYS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91406-5529
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-997-2640
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/20/2007