Provider Demographics
NPI:1205916947
Name:COHEN, PAUL ERIC (MFT)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:ERIC
Last Name:COHEN
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:599 S BARRANCA AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723
Mailing Address - Country:US
Mailing Address - Phone:626-332-3431
Mailing Address - Fax:626-332-8978
Practice Address - Street 1:599 S BARRANCA AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723
Practice Address - Country:US
Practice Address - Phone:626-332-3431
Practice Address - Fax:626-332-8978
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC30794106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist