Provider Demographics
NPI:1710384755
Name:JON HERSHFIELD, MFT, A MARRIAGE AND FAMILY THERAPY CORPORATION
Entity Type:Organization
Organization Name:JON HERSHFIELD, MFT, A MARRIAGE AND FAMILY THERAPY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HERSHFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:424-256-9312
Mailing Address - Street 1:10350 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-5055
Mailing Address - Country:US
Mailing Address - Phone:424-256-9312
Mailing Address - Fax:
Practice Address - Street 1:10350 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5055
Practice Address - Country:US
Practice Address - Phone:424-256-9312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC50490106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty