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Yudha Mann Adiputera
Mental Health Counselor in Culver City, California
NPI 1275014037

Yudha Mann Adiputera is a Mental Health Counselor based in Culver City, CA and is specialized in Mental Health. Yudha Mann Adiputera practices in Culver City, CA. The NPI Number for Yudha Mann Adiputera is 1275014037 and holds a License No. ASW110428 (California).

The current practice location address for Yudha Mann Adiputera is 4760 Sepulveda Blvd, Culver City, CA and can be reached out via phone at 310-390-6612.

Location: 4760 Sepulveda Blvd, Culver City, CA, 90230-4820
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1275014037
Provider Name
Yudha Mann Adiputera
Credential
Provider Entity Type
Individual
Gender
Male
Address
4760 Sepulveda Blvd, Culver City, CA, 90230-4820
Phone Number
310-390-6612
Fax Number
Provider Enumeration Date
08/28/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4760 Sepulveda Blvd
City
Culver City
State
California
Zip
90230-4820
Phone Number
310-390-6612
Fax Number
person
Provider Business Mailing Address Details
Address
4760 Sepulveda Blvd
City
Culver City
State
California
Zip
90230-4820
Phone Number
310-390-6612
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
ASW110428 (California)
Definition
Definition to come...
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