| Annick Julia Tytgat, | |
|
130 W Victoria St, Gardena, CA 90248-3523 | |
| (310) 715-2020 | |
| Not Available |
| Full Name | Annick Julia Tytgat |
|---|---|
| Gender | Female |
| Speciality | Marriage & Family Therapist |
| Location | 130 W Victoria St, Gardena, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417391517 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | LMFT91098 (California) | Primary |
| Entity Name | Permanente Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
| Mailing Address | Practice Location Address |
|---|---|
| Annick Julia Tytgat, 130 W Victoria St, Gardena, CA 90248-3523 Ph: (310) 715-2020 | Annick Julia Tytgat, 130 W Victoria St, Gardena, CA 90248-3523 Ph: (310) 715-2020 |
Mrs. Iva Svetlikova, M.S. MFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 108 W Victoria St, Gardena, CA 90248 Phone: 310-715-2020 Fax: 310-660-0494 | |
Mrs. Sayo Matsuda, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 108 W Victoria St, Gardena, CA 90248 Phone: 424-757-4226 | |
Mr. Khai Hoang Nguyen, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 108 W Victoria St, Gardena, CA 90248 Phone: 310-715-2020 | |
Ms. Manuela Christine Siriaco, M.A. Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 130 W Victoria St, Gardena, CA 90248 Phone: 310-715-2020 | |
Edward Albert Del Hierro, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 108 W Victoria St, Gardena, CA 90248 Phone: 310-715-2020 | |
Marissa Greenberg, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 3333 W 152nd St, Gardena, CA 90249 Phone: 646-568-0047 | |
Mrs. Rheannon Chavez, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 108 W Victoria St, Gardena, CA 90248 Phone: 310-715-2020 |