Provider Demographics
NPI:1326179300
Name:PROBST, JOAN (LMFT)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:
Last Name:PROBST
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 41504
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-0504
Mailing Address - Country:US
Mailing Address - Phone:323-256-8533
Mailing Address - Fax:
Practice Address - Street 1:7003 N FIGUEROA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-1247
Practice Address - Country:US
Practice Address - Phone:323-543-4201
Practice Address - Fax:323-257-6418
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC29839106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist