Provider Demographics
NPI:1326222019
Name:STUART L ZUBRICK MARRIAGE FAMILY AND CHILD COUNSELING A PROF CORP
Entity Type:Organization
Organization Name:STUART L ZUBRICK MARRIAGE FAMILY AND CHILD COUNSELING A PROF CORP
Other - Org Name:INDUSTRIAL HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZUBRICK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:213-739-0019
Mailing Address - Street 1:3435 WILSHIRE BLVD
Mailing Address - Street 2:STE. 2700-80
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-1901
Mailing Address - Country:US
Mailing Address - Phone:213-739-0019
Mailing Address - Fax:213-739-0091
Practice Address - Street 1:3435 WILSHIRE BLVD
Practice Address - Street 2:STE. 2700-80
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-1901
Practice Address - Country:US
Practice Address - Phone:213-739-0019
Practice Address - Fax:213-739-0091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC0700X
CAPSY7352103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty