Basic Information
| Provider Information | |||||||||
| NPI: | 1679822241 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARVEY | ||||||||
| FirstName: | TRINA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 605 W OLYMPIC BLVD | ||||||||
| Address2: | SUITE 600 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2135531800 | ||||||||
| FaxNumber: | 2135531822 | ||||||||
| Practice Location | |||||||||
| Address1: | 2120 W 8TH STREET | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2133681888 | ||||||||
| FaxNumber: | 2133686888 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2012 | ||||||||
| LastUpdateDate: | 08/29/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.