Provider Demographics
NPI:1275997041
Name:RAMKEESOON, KHAN (LMFT106719)
Entity Type:Individual
Prefix:
First Name:KHAN
Middle Name:
Last Name:RAMKEESOON
Suffix:
Gender:F
Credentials:LMFT106719
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5199 E PACIFIC COAST HWY STE 312N
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-3344
Mailing Address - Country:US
Mailing Address - Phone:562-310-0111
Mailing Address - Fax:
Practice Address - Street 1:5199 E PACIFIC COAST HWY STE 312N
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-3344
Practice Address - Country:US
Practice Address - Phone:562-310-0111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-07
Last Update Date:2020-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF76880106H00000X
CA106719106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist