Provider Demographics
NPI:1033415898
Name:LAZARUS, ANDREA MEREDITH (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:MEREDITH
Last Name:LAZARUS
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:MRS
Other - First Name:ANDREA
Other - Middle Name:MEREDITH
Other - Last Name:LAZARUS-MARQUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LMFT
Mailing Address - Street 1:1412 OLDBURY PL
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-1525
Mailing Address - Country:US
Mailing Address - Phone:818-674-1216
Mailing Address - Fax:
Practice Address - Street 1:125 W THOUSAND OAKS BLVD STE 600
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4463
Practice Address - Country:US
Practice Address - Phone:805-777-3563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-26
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37989106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist