Individual
ANTHONY JASON DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5054 S VERMONT AVE, LOS ANGELES, CA 90037-2946
(323) 373-2444
Mailing address
3031 S VERMONT AVE, LOS ANGELES, CA 90007-3033
(323) 373-2400
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
31881
CA
1041C0700X
Clinical Social Worker
Primary
65441
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
65441
LCSW
CA
Enumeration date
09/18/2009
Last updated
08/24/2020
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