Provider Demographics
NPI:1518374917
Name:MOLINA, ABIGAIL (MA)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:MOLINA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:
Other - Last Name:PALMER MOLINA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:713 S PACIFIC COAST HWY STE C
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-4233
Mailing Address - Country:US
Mailing Address - Phone:424-258-0162
Mailing Address - Fax:
Practice Address - Street 1:713 S PACIFIC COAST HWY STE C
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-4233
Practice Address - Country:US
Practice Address - Phone:424-258-0162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-17
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW61570101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health