Provider Demographics
NPI:1710001375
Name:COHEN, VERONICA SARAH (MA)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:SARAH
Last Name:COHEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12624 ROSE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-1551
Mailing Address - Country:US
Mailing Address - Phone:310-895-8471
Mailing Address - Fax:
Practice Address - Street 1:3910 OAKWOOD AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-3413
Practice Address - Country:US
Practice Address - Phone:323-953-7350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF51349106H00000X
CALMFT 50511106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist