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Organization
TIMOTHY COLLISTER PHD, INC.
Active
Organization
TIMOTHY COLLISTER PHD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARLA ELIZABETH PEREZ M.A. (MFT INTERN)
(626) 914-9609
Entity
Organization
Contact information
Practice address
7024 SEVILLE AVE STE D, HUNTINGTON PARK, CA 90255-4969
(323) 588-9600
(323) 588-9696
Mailing address
13525 TRACY ST APT A, BALDWIN PARK, CA 91706-4766
(626) 813-9548
(626) 813-9548
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
IMF51448
CA
Other
Enumeration date
03/20/2007
Last updated
08/22/2020
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