Provider Demographics
NPI:1053736082
Name:KAUFMAN, MICHAEL (LMFT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 89
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-0089
Mailing Address - Country:US
Mailing Address - Phone:310-285-3743
Mailing Address - Fax:
Practice Address - Street 1:3201 WILSHIRE BLVD
Practice Address - Street 2:SUITE 209
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-2344
Practice Address - Country:US
Practice Address - Phone:310-285-3743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC44677106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist