Provider Demographics
NPI:1508994583
Name:LAIDLEY, ANA (LMFT)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:LAIDLEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8717 S 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90305-2324
Mailing Address - Country:US
Mailing Address - Phone:310-677-7004
Mailing Address - Fax:
Practice Address - Street 1:6736 LAUREL CANYON BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-1538
Practice Address - Country:US
Practice Address - Phone:818-755-8786
Practice Address - Fax:818-755-8789
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC44112106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist