Provider Demographics
NPI:1104846500
Name:LESTER, ROBERTA (MFT)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:
Last Name:LESTER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 S PACIFIC COAST HWY
Mailing Address - Street 2:SUITE H
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-5612
Mailing Address - Country:US
Mailing Address - Phone:310-944-9292
Mailing Address - Fax:
Practice Address - Street 1:1617 S PACIFIC COAST HWY
Practice Address - Street 2:SUITE H
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-5612
Practice Address - Country:US
Practice Address - Phone:310-944-9292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAM13384106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist