De Long, Theresa

De Long, Theresa is an individual health care provider with primary practice located at 2730 Wilshire Blvd Suite 660, Santa Monica CA 90403. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. De Long, Theresa can be contacted via phone (310) 383-0779.

Contact Information

Primary practice address
2730 Wilshire Blvd Suite 660 Santa Monica CA 90403
Phone: (310) 383-0779
Fax: (310) 410-9507
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X

Profile Details

NPI number 1447592555
LBN Legal business name De Long, Theresa
Credentials Marriage and Family Therapist (MFT)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2013
Last updated Jul 9th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447592555 NPPES
California Other MFC 52307 LICENSE

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