Basic Information
| Provider Information | |||||||||
| NPI: | 1508150210 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAMBERS | ||||||||
| FirstName: | BRONWYN | ||||||||
| MiddleName: | AARON | ||||||||
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| Credential: | M.A., MFT INTERN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 864 S ROBERTSON BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900351628 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8185746214 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 21081 S WESTERN AVE STE 295 | ||||||||
| Address2: | |||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905011707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3105336600 | ||||||||
| FaxNumber: | 3107879036 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2011 | ||||||||
| LastUpdateDate: | 05/31/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | IMF58823 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.