Provider Demographics
NPI:1912116534
Name:C. G. JUNG INSTITUTE OF LOS ANGELES
Entity Type:Organization
Organization Name:C. G. JUNG INSTITUTE OF LOS ANGELES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-556-1193
Mailing Address - Street 1:10349 W PICO BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-2608
Mailing Address - Country:US
Mailing Address - Phone:310-556-1193
Mailing Address - Fax:310-556-2290
Practice Address - Street 1:10349 W PICO BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-2608
Practice Address - Country:US
Practice Address - Phone:310-556-1193
Practice Address - Fax:310-556-2290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health