Provider Demographics
NPI:1437263787
Name:ADAMS, BRIAN E (LMFT)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:E
Last Name:ADAMS
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 1:333 N LANTANA ST STE 269
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-9008
Mailing Address - Country:US
Mailing Address - Phone:805-207-7051
Mailing Address - Fax:805-383-4565
Practice Address - Street 1:333 N LANTANA ST STE 269
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-9008
Practice Address - Country:US
Practice Address - Phone:805-207-7051
Practice Address - Fax:805-383-4565
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT42840106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist