Provider Demographics
NPI:1164056487
Name:BAKMAN, PAIGE (LMFT)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:BAKMAN
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 1:16501 VENTURA BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2067
Mailing Address - Country:US
Mailing Address - Phone:818-325-5920
Mailing Address - Fax:
Practice Address - Street 1:16501 VENTURA BLVD STE 400
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2067
Practice Address - Country:US
Practice Address - Phone:818-325-5920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-25
Last Update Date:2023-09-12
Deactivation Date:2023-03-06
Deactivation Code:
Reactivation Date:2023-09-08
Provider Licenses
StateLicense IDTaxonomies
CA115024106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist