Most Relevant Information
Provider Data
| NPI Number: | 1003474636 |
| Provider Name: | ANGELICA MARIE CHURCHIAN LMFT |
| Entity Type: | Individual |
| Taxonomy Code: | 106H00000X |
| Specialty: | Marriage & Family Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/29/2019 |
| Last Updated: | 05/07/2021 |
Provider Practice Location
11643 GLENOAKS BLVD
PACOIMA
CA
913311099
Practice Location Phone/Fax
| Phone: | 3107515408 |
| Fax: |
Provider Mailing Location
4760 SEPULVEDA BLVD
CULVER CITY
CA
902304820
Provider Mailing Phone/Fax
| Phone: | 3103906612 |
| Fax: |