Provider Demographics
NPI:1104999689
Name:BLEDMAN, ASPALTHA CARL
Entity type:Individual
Prefix:
First Name:ASPALTHA
Middle Name:CARL
Last Name:BLEDMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6211 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043-4213
Mailing Address - Country:US
Mailing Address - Phone:323-753-2935
Mailing Address - Fax:
Practice Address - Street 1:11539 HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-2325
Practice Address - Country:US
Practice Address - Phone:310-263-2154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor