Provider Demographics
NPI:1922156173
Name:BARTELSTEIN, ANN (MFT)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:BARTELSTEIN
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 1:1516 WESTWOOD BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-5617
Mailing Address - Country:US
Mailing Address - Phone:310-474-5363
Mailing Address - Fax:
Practice Address - Street 1:1516 WESTWOOD BLVD STE 205
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-5617
Practice Address - Country:US
Practice Address - Phone:310-474-5363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 40812106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist