Doctor Name: | MR. KEITH DAVID ATTARDO |
NPI Number: | 1003049560 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S. , MFT |
License Number: | MFC44200 |
Business Practice Address: | 4132 Katella Ave Ste 104 Los Alamitos, CA - 907203493 |
Business Phone Number: | 5622344194 |
Business Fax Number: | |
Mailing Address: | 4132 Katella Ave Ste 104, LOS ALAMITOS |
State: | CA |
Postal Code: | 907203493 |
Phone Number: | 5622344194 |
Fax Number: | |
NPI Enumeration Date: | 09/01/2009 |
NPI Last Update Date: | 09/01/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | MFC44200 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |