Provider Demographics
NPI:1225629314
Name:LABRENZ, ANNELISE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ANNELISE
Middle Name:
Last Name:LABRENZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ANNELISE
Other - Middle Name:
Other - Last Name:GAETANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1520 REDWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-6335
Mailing Address - Country:US
Mailing Address - Phone:916-753-3928
Mailing Address - Fax:
Practice Address - Street 1:2765 CABOT CT
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-1640
Practice Address - Country:US
Practice Address - Phone:916-753-3928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-01
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA139664106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist