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Provider Information for 1578694410


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Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

Ms. MOUSHUMI G GHOSE MFT


Sex: Female

NPI: 1578694410
Last Updated: 2023-04-19
Certification Date: 2023-04-19

Details

NameValue
NPI1578694410
Enumeration Date2007-03-09
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 1625 N SUMNER ST
PORTLAND, OR 97217-3745
United States

Phone: 323-739-4250 | Fax:818-936-0593
 
Primary Practice Address 201 N BRAND BLVD UNIT 200
GLENDALE, CA 91203-3590
United States

Phone: 323-397-4250 | Fax:818-936-0593
 
Secondary Practice Address(es)

1625 N SUMNER ST
PORTLAND, OR 97217-3745
United States

Phone: 323-739-4250 | Fax:818-936-0593
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 106H00000X - Marriage & Family Therapist CA44134
Yes 106H00000X - Marriage & Family Therapist CAMFC44134