Provider Demographics
NPI:1578946992
Name:GARBIN, ANGELA (MFT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:GARBIN
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 1:109 N SYCAMORE AVE APT 403
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-2953
Mailing Address - Country:US
Mailing Address - Phone:646-831-0816
Mailing Address - Fax:
Practice Address - Street 1:109 N SYCAMORE AVE
Practice Address - Street 2:APT 403
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-2959
Practice Address - Country:US
Practice Address - Phone:646-831-0816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-02
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32593103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist