Basic Information
| Provider Information | |||||||||
| NPI: | 1588248934 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LA CAPRIA | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6219 E. PACIFIC COAST HWY | ||||||||
| Address2: | 90 | ||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3238915877 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2272 PACIFIC AVE | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908064312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5624278018 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2021 | ||||||||
| LastUpdateDate: | 05/11/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | A051520919 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.