Provider Demographics
NPI:1821767393
Name:LOMBRANA, JAMIE LEE (MFT TRAINEE)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEE
Last Name:LOMBRANA
Suffix:
Gender:F
Credentials:MFT TRAINEE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 S KENMORE AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-1540
Mailing Address - Country:US
Mailing Address - Phone:830-734-8392
Mailing Address - Fax:
Practice Address - Street 1:849 E 6TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90021-1026
Practice Address - Country:US
Practice Address - Phone:213-623-8446
Practice Address - Fax:213-896-1880
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program