| Doctor Name: | AMY EBERT |
| NPI Number: | 1124441662 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 00317065 |
| Business Practice Address: | 7101 Baird Ave Reseda, CA - 913354150 |
| Business Phone Number: | 8183425897 |
| Business Fax Number: | 8189755009 |
| Mailing Address: | 5416 Fair Ave, NORTH HOLLYWOOD |
| State: | CA |
| Postal Code: | 916012732 |
| Phone Number: | 8183425897 |
| Fax Number: | 8189755008 |
| NPI Enumeration Date: | 02/03/2014 |
| NPI Last Update Date: | 02/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 00317065 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |