Provider Demographics
NPI:1801926977
Name:MATTSSON, MALIN CATARINA (MA)
Entity type:Individual
Prefix:MS
First Name:MALIN
Middle Name:CATARINA
Last Name:MATTSSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3749 W 58TH PL
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043-2909
Mailing Address - Country:US
Mailing Address - Phone:310-625-5124
Mailing Address - Fax:
Practice Address - Street 1:3749 W 58TH PL
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90043-2909
Practice Address - Country:US
Practice Address - Phone:310-625-5124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC47861106H00000X
CALMFT47861106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist