Individual
CHERYL L BAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4240 W 62ND ST, LOS ANGELES, CA 90043-3615
(323) 290-2540
Mailing address
5757 W CENTURY BLVD STE 303, LOS ANGELES, CA 90045-6409
(323) 290-2540
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
225C00000X
Rehabilitation Counselor
—
—
Other
Enumeration date
06/04/2021
Last updated
09/15/2021
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