Provider Demographics
NPI:1326335522
Name:RCHTOUNI, INNESA (MS, LMFT)
Entity Type:Individual
Prefix:MISS
First Name:INNESA
Middle Name:
Last Name:RCHTOUNI
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 S PARISH PL
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2742
Mailing Address - Country:US
Mailing Address - Phone:323-316-6512
Mailing Address - Fax:
Practice Address - Street 1:12821 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3012
Practice Address - Country:US
Practice Address - Phone:818-432-5052
Practice Address - Fax:818-760-9092
Is Sole Proprietor?:No
Enumeration Date:2011-07-08
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA112654106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist