Provider Demographics
NPI:1174882302
Name:VAUGHN, EMILY SEARS (MFCT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:SEARS
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:MFCT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6206 BECKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-6634
Mailing Address - Country:US
Mailing Address - Phone:818-705-8654
Mailing Address - Fax:
Practice Address - Street 1:6206 BECKFORD AVE
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91335-6634
Practice Address - Country:US
Practice Address - Phone:818-705-8654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-08
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC29323106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist