Organization
SAN PEDRO HEALING ARTS MEDICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE FIAMENGO LMFT (EXECUTIVE DIRECTOR)
(310) 547-2197
Entity
Organization
Contact information
Practice address
22706 ASPAN ST, SUITE 702, LAKE FOREST, CA 92630-1603
(949) 427-1013
Mailing address
1366 W 7TH ST, SUITE 4B, SAN PEDRO, CA 90732-3500
(310) 547-2197
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PCCI 1592
CA
Other
Enumeration date
06/04/2015
Last updated
06/04/2015
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