Provider Demographics
NPI:1114210457
Name:BABUGLIA, SILVANA LOURDES I (MFT-I)
Entity Type:Individual
Prefix:
First Name:SILVANA
Middle Name:LOURDES
Last Name:BABUGLIA
Suffix:I
Gender:F
Credentials:MFT-I
Other - Prefix:
Other - First Name:SILVANA
Other - Middle Name:LOURDES
Other - Last Name:BABUGLIA
Other - Suffix:I
Other - Last Name Type:Former Name
Other - Credentials:MFT-I
Mailing Address - Street 1:130 W VICTORIA ST
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90248-3523
Mailing Address - Country:US
Mailing Address - Phone:310-715-2020
Mailing Address - Fax:
Practice Address - Street 1:130 W VICTORIA ST
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90248-3523
Practice Address - Country:US
Practice Address - Phone:310-715-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-19
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CA65902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)