Provider Demographics
NPI:1417228834
Name:LYNN VALVERDE THERAPY
Entity Type:Organization
Organization Name:LYNN VALVERDE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:VALVERDE
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:310-582-5250
Mailing Address - Street 1:11911 SAN VICENTE BLVD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-5086
Mailing Address - Country:US
Mailing Address - Phone:310-582-5250
Mailing Address - Fax:310-582-5250
Practice Address - Street 1:11911 SAN VICENTE BLVD
Practice Address - Street 2:SUITE 240
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-5086
Practice Address - Country:US
Practice Address - Phone:310-582-5250
Practice Address - Fax:310-582-5250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-17
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42999106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty