Provider Demographics
NPI:1699079749
Name:SINGLETON, STANLEY KEITH
Entity type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:KEITH
Last Name:SINGLETON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1897 W JEFFERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90018-3434
Mailing Address - Country:US
Mailing Address - Phone:323-735-2390
Mailing Address - Fax:
Practice Address - Street 1:1897 W JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90018-3434
Practice Address - Country:US
Practice Address - Phone:323-735-2390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health