Provider Demographics
NPI:1568775062
Name:HARRRIS, MARIA DOLORES (MFT)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:DOLORES
Last Name:HARRRIS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13749 RIVERSIDE DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2415
Mailing Address - Country:US
Mailing Address - Phone:818-667-1568
Mailing Address - Fax:
Practice Address - Street 1:13749 RIVERSIDE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2415
Practice Address - Country:US
Practice Address - Phone:818-667-1568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 47264106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist