Provider Information for 1215133822
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KEVIN BRUCE WURTZ LMFT
Sex: Male
NPI: 1215133822
Last Updated: 2015-02-17
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1215133822 | ||||||||
| Enumeration Date | 2007-06-22 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2061 SAN VICENTE AVE LONG BEACH, CA 90815-3259 United States Phone: 562-606-3885 | Fax: | ||||||||
| Primary Practice Address | 11721 TELEGRAPH RD SANTA FE SPRINGS, CA 90670-3674 United States Phone: 562-949-8455 | Fax: | ||||||||
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