Provider Demographics
NPI:1457014508
Name:JAMES, TYLO (AMFT 144855)
Entity type:Individual
Prefix:
First Name:TYLO
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:AMFT 144855
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 CENTINELA AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302-1045
Mailing Address - Country:US
Mailing Address - Phone:424-750-9293
Mailing Address - Fax:
Practice Address - Street 1:1620 CENTINELA AVE STE 207
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-1045
Practice Address - Country:US
Practice Address - Phone:424-750-9293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-15
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171M00000X
CA144855106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator