Provider Demographics
NPI:1609153246
Name:SOBEL, MELINDA R (MFT)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:R
Last Name:SOBEL
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 1:9090 WILSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1848
Mailing Address - Country:US
Mailing Address - Phone:310-888-8680
Mailing Address - Fax:310-888-1886
Practice Address - Street 1:9090 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1848
Practice Address - Country:US
Practice Address - Phone:310-888-8680
Practice Address - Fax:310-888-1886
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT41625106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist