Provider Demographics
NPI:1619397155
Name:BRYAN, KAREN (LMFT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BRYAN
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 1:315 S BEVERLY DR
Mailing Address - Street 2:SUITE 307
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4312
Mailing Address - Country:US
Mailing Address - Phone:310-528-2222
Mailing Address - Fax:
Practice Address - Street 1:315 S BEVERLY DR
Practice Address - Street 2:SUITE 307
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-4312
Practice Address - Country:US
Practice Address - Phone:310-528-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 39576106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist