Provider Demographics
NPI:1295217768
Name:HAUSMAN, ANN ROCHELLE (LEP, LMFT)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:ROCHELLE
Last Name:HAUSMAN
Suffix:
Gender:F
Credentials:LEP, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29269 LAS TERRENO LN
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91354-1546
Mailing Address - Country:US
Mailing Address - Phone:661-618-6569
Mailing Address - Fax:
Practice Address - Street 1:24359 WALNUT ST STE A
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-6101
Practice Address - Country:US
Practice Address - Phone:661-287-0124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23423106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA23423OtherCALIFORNIA BOARD OF BEHAVIORAL SCIENCES
CA1548OtherCALIFORNIA BOARD OF BEHAVIORAL SCIENCES