Provider Demographics
NPI:1184045403
Name:SHEREE JONES-PISTOL, A MARRIAGE AND FAMILY THERAPY CORPORATION
Entity Type:Organization
Organization Name:SHEREE JONES-PISTOL, A MARRIAGE AND FAMILY THERAPY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEREE
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:JONES-PISTOL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:818-705-5652
Mailing Address - Street 1:18375 VENTURA BOULEVARD
Mailing Address - Street 2:SUITE 309
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4218
Mailing Address - Country:US
Mailing Address - Phone:818-705-5652
Mailing Address - Fax:818-715-7876
Practice Address - Street 1:9003 RESEDA BOULEVARD
Practice Address - Street 2:SUITE 206
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-3961
Practice Address - Country:US
Practice Address - Phone:818-705-5652
Practice Address - Fax:818-705-7876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-05
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36905106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1992953475OtherNPPES