Provider Demographics
NPI:1265678866
Name:PRESSNALL, DOVE (LMFT)
Entity Type:Individual
Prefix:
First Name:DOVE
Middle Name:
Last Name:PRESSNALL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27774
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-0774
Mailing Address - Country:US
Mailing Address - Phone:323-319-3613
Mailing Address - Fax:
Practice Address - Street 1:4607 PROSPECT AVE
Practice Address - Street 2:NORTH RODNEY ENTRANCE
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5304
Practice Address - Country:US
Practice Address - Phone:323-319-3613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-02
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 38179106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFT381790OtherBLUE SHIELD PIN