Provider Demographics
NPI:1093490484
Name:CROSS, ADAM M (LMFT)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:M
Last Name:CROSS
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 1:1985 YOSEMITE AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-5200
Mailing Address - Country:US
Mailing Address - Phone:805-428-3755
Mailing Address - Fax:
Practice Address - Street 1:1985 YOSEMITE AVE STE 230
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-5200
Practice Address - Country:US
Practice Address - Phone:805-428-3755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA116623106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist