Provider Demographics
NPI:1568677987
Name:BRUCKER, VALERIE (LMFT)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:BRUCKER
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 1:1314 WESTWOOD BLVD
Mailing Address - Street 2:# 210
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-4902
Mailing Address - Country:US
Mailing Address - Phone:310-474-6929
Mailing Address - Fax:
Practice Address - Street 1:1314 WESTWOOD BLVD
Practice Address - Street 2:# 210
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-4902
Practice Address - Country:US
Practice Address - Phone:310-474-6929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT15145106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist