Individual
HENRY WIJATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
3850 CRENSHAW BLVD, LOS ANGELES, CA 90008-1821
(323) 751-3026
Mailing address
3850 CRENSHAW BLVD, LOS ANGELES, CA 90008-1821
(323) 751-3026
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1037
KS
101YP2500X
Professional Counselor
Primary
5327
CA
Other
Enumeration date
10/09/2007
Last updated
08/30/2021
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