Provider Demographics
NPI:1497437172
Name:FINE, SAVANNAH MONTINE (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:MONTINE
Last Name:FINE
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28179 RIDGECOVE CT S
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-7227
Mailing Address - Country:US
Mailing Address - Phone:310-488-6263
Mailing Address - Fax:
Practice Address - Street 1:28179 RIDGECOVE CT S
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-7227
Practice Address - Country:US
Practice Address - Phone:310-488-6263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA139871103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical