| J D Bienenfeld Msw Licensed Clinical Social Workerc Corp Lighthouse Ps | |
|
11122 Riverside Dr Unit 101 West Toluca Lake CA 91602-2186 | |
| (818) 430-2792 | |
| Not Available |
| Full Name | J D Bienenfeld Msw Licensed Clinical Social Workerc Corp Lighthouse Ps |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 11122 Riverside Dr Unit 101, West Toluca Lake, California |
| Authorized Official Name and Position | Joshua David Bienenfeld (CEO) |
| Authorized Official Contact | 8184302792 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J D Bienenfeld Msw Licensed Clinical Social Workerc Corp Lighthouse Ps 4365 E Lowell St Ste H Ontario CA 91761-2226 Ph: (818) 430-2792 | J D Bienenfeld Msw Licensed Clinical Social Workerc Corp Lighthouse Ps 11122 Riverside Dr Unit 101 West Toluca Lake CA 91602-2186 Ph: (818) 430-2792 |
| NPI Number | 1982404919 |
|---|---|
| Provider Enumeration Date | 03/18/2025 |
| Last Update Date | 08/11/2025 |
| Certification Date | 08/08/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982404919 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |