Provider Demographics
NPI:1861683732
Name:BLUMENFELD, JUDY (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:
Last Name:BLUMENFELD
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5318 BRYANT AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1430
Mailing Address - Country:US
Mailing Address - Phone:510-575-9984
Mailing Address - Fax:
Practice Address - Street 1:5318 BRYANT AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1430
Practice Address - Country:US
Practice Address - Phone:510-575-9984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52769106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist