Provider Demographics
NPI:1639295678
Name:ADAL, ANA (MA)
Entity Type:Individual
Prefix:MS
First Name:ANA
Middle Name:
Last Name:ADAL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1231 S ALFRED ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-2534
Mailing Address - Country:US
Mailing Address - Phone:323-244-9613
Mailing Address - Fax:
Practice Address - Street 1:11600 WASHINGTON PL STE 202E
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5068
Practice Address - Country:US
Practice Address - Phone:323-244-9613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47420106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist