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Organization

KAISER PERMANENTE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JIM SELFA LMFT (DEPARTMENT ADMINISTRATOR)
(323) 298-3175
Entity
Organization

Contact information

Practice address
5105 W GOLDLEAF CIR, LOS ANGELES, CA 90056-1269
(323) 298-3175
Mailing address
4440 DENSMORE AVE, ENCINO, CA 91436-3461
(818) 788-9489

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
MFC29709
CA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
MFC29709
CA

Other

Enumeration date
06/05/2007
Last updated
09/11/2025
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