Organization
ANNAN COUNSELING CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENNETT ANNAN PSYD, EDD (PRESIDENT/CEO)
(818) 268-0375
Entity
Organization
Contact information
Practice address
4543 COCHRAN ST APT 237, SIMI VALLEY, CA 93063-0306
(818) 268-0375
Mailing address
4543 COCHRAN ST APT 237, SIMI VALLEY, CA 93063-0306
(818) 268-0375
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003047911
—
CA
Enumeration date
10/06/2021
Last updated
10/06/2021
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