Provider Demographics
NPI:1598096919
Name:STOOKEY, ANNA (MA, MFT, CHT)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:STOOKEY
Suffix:
Gender:F
Credentials:MA, MFT, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2069
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90213-2069
Mailing Address - Country:US
Mailing Address - Phone:323-993-6085
Mailing Address - Fax:
Practice Address - Street 1:447 N LARCHMONT BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-3034
Practice Address - Country:US
Practice Address - Phone:323-993-6085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-25
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44942106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist