Provider Demographics
NPI:1659496289
Name:ZIPKIN, JOSEPH R (MFT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:R
Last Name:ZIPKIN
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5482 WILSHIRE BLVD # 222
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-4218
Mailing Address - Country:US
Mailing Address - Phone:310-480-7966
Mailing Address - Fax:
Practice Address - Street 1:5482 WILSHIRE BLVD # 222
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4218
Practice Address - Country:US
Practice Address - Phone:310-480-7966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 43735106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist