Provider Demographics
NPI:1700258522
Name:HELLSTEN, MATS
Entity Type:Individual
Prefix:
First Name:MATS
Middle Name:
Last Name:HELLSTEN
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 1:440 N BARRANCA AVE # 3734
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-1722
Mailing Address - Country:US
Mailing Address - Phone:510-859-4475
Mailing Address - Fax:
Practice Address - Street 1:24 ERIKSLUSTVAGEN
Practice Address - Street 2:
Practice Address - City:MALMO
Practice Address - State:SWEDEN
Practice Address - Zip Code:21773
Practice Address - Country:SE
Practice Address - Phone:510-859-4475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-21
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88243106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist