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Jose Mata
Student in an Organized Health Care Education/Training Program in Culver City, California
NPI 1578807681

Jose Mata is a Student in an Organized Health Care Education/Training Program based in Culver City, CA. Jose Mata practices in Culver City, CA. The NPI Number for Jose Mata is 1578807681 and holds a License No. (California).

The current practice location address for Jose Mata is 4760 Sepulveda Blvd, Culver City, CA and can be reached out via phone at 917-861-9671.

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
1578807681
Provider Name
Jose Mata
Credential
Provider Entity Type
Individual
Gender
Male
Address
4760 Sepulveda Blvd, Culver City, CA, 90230-4820
Phone Number
917-861-9671
Fax Number
Provider Enumeration Date
11/15/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
01261511 05 CA
institution
Provider Business Practice Location Address Details
Address
4760 Sepulveda Blvd
City
Culver City
State
California
Zip
90230-4820
Phone Number
917-861-9671
Fax Number
person
Provider Business Mailing Address Details
Address
4760 Sepulveda Blvd
City
Culver City
State
California
Zip
90230-4820
Phone Number
917-861-9671
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Marriage & Family Therapist
Speciality
-
Taxonomy
106H00000X
License No.
()
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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