Provider Demographics
NPI:1063848133
Name:ASANTE, EMMANUEL KWABENA JR
Entity Type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:KWABENA
Last Name:ASANTE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14030 LEMOLI AVE
Mailing Address - Street 2:APARTMENT 19
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-8248
Mailing Address - Country:US
Mailing Address - Phone:310-947-5214
Mailing Address - Fax:
Practice Address - Street 1:21730 S VERMONT AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2196
Practice Address - Country:US
Practice Address - Phone:310-222-1613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-20
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health