Provider Demographics
NPI:1871255992
Name:VON HAUMEDER, ANNA-DIANA FRIEDERIKE (MS)
Entity Type:Individual
Prefix:MRS
First Name:ANNA-DIANA
Middle Name:FRIEDERIKE
Last Name:VON HAUMEDER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13101 W WASHINGTON BLVD STE 219
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-5100
Mailing Address - Country:US
Mailing Address - Phone:323-617-8427
Mailing Address - Fax:
Practice Address - Street 1:13101 W WASHINGTON BLVD STE 219
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5100
Practice Address - Country:US
Practice Address - Phone:657-200-1004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-06
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA139556106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist