Provider Demographics
NPI:1407030273
Name:PLUNKETT, AIDAN PETER (LMFT)
Entity Type:Individual
Prefix:MR
First Name:AIDAN
Middle Name:PETER
Last Name:PLUNKETT
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 VAN HORNE LN
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-4735
Mailing Address - Country:US
Mailing Address - Phone:310-386-5874
Mailing Address - Fax:
Practice Address - Street 1:703 PIER AVE
Practice Address - Street 2:STE B - #702
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254-3943
Practice Address - Country:US
Practice Address - Phone:310-386-5874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 44276106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist