Provider Demographics
NPI:1083476774
Name:DAVY, VERONICA (LMFT)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:DAVY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6043 BURWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-1205
Mailing Address - Country:US
Mailing Address - Phone:310-701-4951
Mailing Address - Fax:
Practice Address - Street 1:16 N MARENGO AVE STE 319
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1982
Practice Address - Country:US
Practice Address - Phone:310-701-4951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140959106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist