| The Ed Asner Family Center | |
|
16340 Roscoe Blvd Ste 101 Van Nuys CA 91406-1217 | |
| (818) 855-2199 | |
| Not Available |
| Full Name | The Ed Asner Family Center |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 16340 Roscoe Blvd Ste 101, Van Nuys, California |
| Authorized Official Name and Position | Chrisa Sadd (DIRECTOR OF MENTAL HEALTH) |
| Authorized Official Contact | 8188552199 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Ed Asner Family Center 12400 Ventura Blvd # 371 Studio City CA 91604-2406 Ph: () - | The Ed Asner Family Center 16340 Roscoe Blvd Ste 101 Van Nuys CA 91406-1217 Ph: (818) 855-2199 |
| NPI Number | 1104315621 |
|---|---|
| Provider Enumeration Date | 05/10/2018 |
| Last Update Date | 05/07/2024 |
| Certification Date | 05/07/2024 |
| Medicare PECOS PAC ID | 5092155796 |
|---|---|
| Medicare Enrollment ID | O20240429001642 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104315621 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Desiree Ginette Gonzalez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1841202066 PECOS PAC ID: 1658721709 Enrollment ID: I20240102001693 |
| Provider Name | Chrisa Lynn Sadd |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1184937807 PECOS PAC ID: 5991145690 Enrollment ID: I20240430003478 |
| Provider Name | Kelley M Tapia |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1477790731 PECOS PAC ID: 6305286949 Enrollment ID: I20240430003564 |
| Provider Name | Katayoun Khorramian |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1538741855 PECOS PAC ID: 7012357650 Enrollment ID: I20240430003618 |
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