Provider Demographics
NPI:1831596956
Name:BASS, ARTHUR (MA, LMFT)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:
Last Name:BASS
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 S CANFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-3224
Mailing Address - Country:US
Mailing Address - Phone:310-691-6295
Mailing Address - Fax:
Practice Address - Street 1:10801 NATIONAL BLVD STE 225
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-4146
Practice Address - Country:US
Practice Address - Phone:310-691-6295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-04
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC46818106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist