Provider Demographics
NPI:1679735260
Name:LEVY, LYNDA A (MA, MFT)
Entity type:Individual
Prefix:
First Name:LYNDA
Middle Name:A
Last Name:LEVY
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11110 OHIO AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-3389
Mailing Address - Country:US
Mailing Address - Phone:310-207-9829
Mailing Address - Fax:310-559-6206
Practice Address - Street 1:10281 CRESTA DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-3432
Practice Address - Country:US
Practice Address - Phone:310-836-3733
Practice Address - Fax:310-559-6206
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC43458106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist