Organization
FAMILY SERVICE
Active
Organization
FAMILY SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL HENRY BULLOCK L.C.S.W. (PSYCHOTHERAPIST)
(562) 493-1496
Entity
Organization
Contact information
Practice address
5500 E ATHERTON ST, SUITE #416, LONG BEACH, CA 90815-4016
(562) 493-1496
(562) 493-2092
Mailing address
5500 E ATHERTON ST, SUITE #416, LONG BEACH, CA 90815-4016
(562) 493-1496
(562) 493-2092
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LCS5735
CA
Other
Enumeration date
09/24/2007
Last updated
09/24/2007
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