Provider Demographics
NPI:1871235325
Name:KAMAN, LAURIE ANN (LMFT)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:ANN
Last Name:KAMAN
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 1:1047 KAGAWA ST
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-3836
Mailing Address - Country:US
Mailing Address - Phone:310-245-6615
Mailing Address - Fax:
Practice Address - Street 1:1047 KAGAWA ST
Practice Address - Street 2:
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-3836
Practice Address - Country:US
Practice Address - Phone:310-245-6615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA131479106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist