Provider Demographics
NPI:1679890537
Name:CENTENO, MURIEL
Entity type:Individual
Prefix:
First Name:MURIEL
Middle Name:
Last Name:CENTENO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6742 CLYBOURN AVE
Mailing Address - Street 2:3227
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-2260
Mailing Address - Country:US
Mailing Address - Phone:818-284-8740
Mailing Address - Fax:
Practice Address - Street 1:6742 CLYBOURN AVE
Practice Address - Street 2:3227
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-2260
Practice Address - Country:US
Practice Address - Phone:818-284-8740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)