Provider Demographics
NPI:1700031945
Name:ARMSTEAD, SHIRLEY A (MA,MFTI,SAC)
Entity Type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:A
Last Name:ARMSTEAD
Suffix:
Gender:F
Credentials:MA,MFTI,SAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 HAUSER BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-4724
Mailing Address - Country:US
Mailing Address - Phone:323-861-7347
Mailing Address - Fax:323-937-4031
Practice Address - Street 1:101 N LA BREA AVE STE 301
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-1744
Practice Address - Country:US
Practice Address - Phone:131-041-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF44921106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist