Provider Demographics
NPI:1285851428
Name:SCARR, CARLA BLOOMQUIST (MFT)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:BLOOMQUIST
Last Name:SCARR
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16255 VENTURA BLVD
Mailing Address - Street 2:SUITE 806
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2302
Mailing Address - Country:US
Mailing Address - Phone:818-522-9370
Mailing Address - Fax:
Practice Address - Street 1:16255 VENTURA BLVD
Practice Address - Street 2:SUITE 806
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2302
Practice Address - Country:US
Practice Address - Phone:818-522-9370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 25819106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist