Basic Information
Provider Information
NPI: 1659408094
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PERRIN
FirstName: FRANCINE
MiddleName: S
NamePrefix: MISS
NameSuffix:  
Credential: PHD MFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5151 WHITE OAK
Address2: #315
City: ENCINO
State: CA
PostalCode: 91316
CountryCode: US
TelephoneNumber: 8186099002
FaxNumber:  
Practice Location
Address1: 1436 GOODRICH
Address2: ENKI HEALTH AND RESEARCH SYSTEMS COMMERCE SITE
City: COMMERCE
State: CA
PostalCode: 90022
CountryCode: US
TelephoneNumber: 3237251337
FaxNumber: 3232785344
Other Information
ProviderEnumerationDate: 02/27/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000XMFT 27426CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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