Provider Demographics
NPI:1538495650
Name:LANNING, PHYLLIS D (LMFT)
Entity Type:Individual
Prefix:MS
First Name:PHYLLIS
Middle Name:D
Last Name:LANNING
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 1:27024 EDGEWATER LN
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1608
Mailing Address - Country:US
Mailing Address - Phone:818-458-7694
Mailing Address - Fax:818-704-4252
Practice Address - Street 1:27024 EDGEWATER LN
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1608
Practice Address - Country:US
Practice Address - Phone:818-458-7694
Practice Address - Fax:818-704-4252
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC31792106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist