Provider Demographics
NPI:1760798300
Name:PARTEE, ALICIA LAVONNE (LMFT)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:LAVONNE
Last Name:PARTEE
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 1:11419 CASIMIR AVE
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-1100
Mailing Address - Country:US
Mailing Address - Phone:323-365-0342
Mailing Address - Fax:310-637-0473
Practice Address - Street 1:11419 CASIMIR AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-1100
Practice Address - Country:US
Practice Address - Phone:323-365-0342
Practice Address - Fax:310-637-0473
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 52857106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA01245407OtherMEDI-CAL PROVIDER