Provider Demographics
NPI:1861628042
Name:HABSCHMIDT, JOAN ANN (MFT)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:ANN
Last Name:HABSCHMIDT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12012 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1207
Mailing Address - Country:US
Mailing Address - Phone:310-207-6334
Mailing Address - Fax:
Practice Address - Street 1:12012 WILSHIRE BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1207
Practice Address - Country:US
Practice Address - Phone:310-207-6334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAM.F.T.22636106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist