Provider Demographics
NPI:1922865641
Name:BATTISTA, KEITH (AMFT, APCC)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:
Last Name:BATTISTA
Suffix:
Gender:M
Credentials:AMFT, APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 LAUREL CANYON BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-1562
Mailing Address - Country:US
Mailing Address - Phone:818-901-4879
Mailing Address - Fax:818-997-1370
Practice Address - Street 1:6400 LAUREL CANYON BLVD STE 500
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-1562
Practice Address - Country:US
Practice Address - Phone:818-901-4879
Practice Address - Fax:818-997-1370
Is Sole Proprietor?:No
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist