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Organization
UCLA TIES FOR FAMILIES
Active
Organization
UCLA TIES FOR FAMILIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDRA LANGLEY PH.D (DIRECTOR)
(310) 794-2457
Entity
Organization
Contact information
Practice address
1033 GAYLEY AVE, SUITE 204, LOS ANGELES, CA 90024-3417
(310) 794-2457
Mailing address
1000 VETERAN AVE, LOS ANGELES, CA 90024-2704
(310) 794-2457
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000007446
—
CA
Enumeration date
11/09/2009
Last updated
10/16/2014
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