Provider Demographics
NPI:1659401859
Name:WILKERSON, KAMEELAH WAHEED (LMFT)
Entity Type:Individual
Prefix:
First Name:KAMEELAH
Middle Name:WAHEED
Last Name:WILKERSON
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 1:210 S DE LACEY AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2048
Mailing Address - Country:US
Mailing Address - Phone:626-395-7100
Mailing Address - Fax:626-395-7270
Practice Address - Street 1:210 S DE LACEY AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2048
Practice Address - Country:US
Practice Address - Phone:626-395-7100
Practice Address - Fax:626-395-7270
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist