Provider Demographics
NPI:1700409174
Name:CURTIS, WALTER LANCE (LMFT)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:LANCE
Last Name:CURTIS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 KROLL WAY APT 227
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-1112
Mailing Address - Country:US
Mailing Address - Phone:818-917-7867
Mailing Address - Fax:661-325-4345
Practice Address - Street 1:3801 BUCK OWENS BLVD STE 105
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-4958
Practice Address - Country:US
Practice Address - Phone:661-325-4357
Practice Address - Fax:661-325-4345
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114635106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist