Provider Demographics
NPI:1487821336
Name:FILAMOR, CAROLINA KENNEDY (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINA
Middle Name:KENNEDY
Last Name:FILAMOR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:KENNEDY
Other - Last Name:FILAMOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:1900 ROYALTY DR
Mailing Address - Street 2:STE. 180
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-3032
Mailing Address - Country:US
Mailing Address - Phone:909-762-0214
Mailing Address - Fax:
Practice Address - Street 1:1900 ROYALTY DR
Practice Address - Street 2:STE. 180
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-3032
Practice Address - Country:US
Practice Address - Phone:909-762-0214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CAIMF56102225400000X
CAMFC 52707106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner