Provider Demographics
NPI:1225060577
Name:KAMMERMAN, ALICE U (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:U
Last Name:KAMMERMAN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2564 STATE ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1662
Mailing Address - Country:US
Mailing Address - Phone:760-729-4931
Mailing Address - Fax:760-729-3846
Practice Address - Street 1:2564 STATE ST
Practice Address - Street 2:SUITE B
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1662
Practice Address - Country:US
Practice Address - Phone:760-729-4931
Practice Address - Fax:760-729-3846
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC22287106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist