Provider Demographics
NPI:1316558315
Name:ALLISON M. LANDA, MA LMFT LICENSED MARRIAGE AND FAMILY THERAPIST PC
Entity Type:Organization
Organization Name:ALLISON M. LANDA, MA LMFT LICENSED MARRIAGE AND FAMILY THERAPIST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:LANDA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:951-268-0556
Mailing Address - Street 1:39514 VIA MONSERATE
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-5571
Mailing Address - Country:US
Mailing Address - Phone:909-224-2283
Mailing Address - Fax:
Practice Address - Street 1:25096 JEFFERSON AVE STE C
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-1706
Practice Address - Country:US
Practice Address - Phone:951-268-0556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1386277135OtherNPI
CA1780962043OtherNPI