Individual
MS. AMY PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., M.A.
Contact information
Practice address
15317 RAYEN ST, NORTH HILLS, CA 91343-5117
(818) 892-3423
(818) 893-4509
Mailing address
15317 RAYEN ST, NORTH HILLS, CA 91343-5117
(818) 892-3423
(818) 893-4509
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
#95-2633765
MEDI-CAL
CA
Enumeration date
09/15/2009
Last updated
03/13/2013
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