Basic Information
| Provider Information | |||||||||
| NPI: | 1649721804 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DIDI HIRSCH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1233 S LA CIENEGA BLVD | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900352520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3108550031 | ||||||||
| FaxNumber: | 3108550138 | ||||||||
| Practice Location | |||||||||
| Address1: | 1233 S LA CIENEGA BLVD | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900352520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3108550031 | ||||||||
| FaxNumber: | 3108550138 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2016 | ||||||||
| LastUpdateDate: | 10/21/2016 | ||||||||
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| AuthorizedOfficialLastName: | THOMAS | ||||||||
| AuthorizedOfficialFirstName: | KATHARINE | ||||||||
| AuthorizedOfficialMiddleName: | ROSE | ||||||||
| AuthorizedOfficialTitleorPosition: | COUNSELOR | ||||||||
| AuthorizedOfficialTelephone: | 2133081413 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor |
No ID Information.