Provider Demographics
NPI:1013657782
Name:KANE, JAMES (MFT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:KANE
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3108 GLENDALE BLVD # 489
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-1806
Mailing Address - Country:US
Mailing Address - Phone:323-546-7652
Mailing Address - Fax:
Practice Address - Street 1:3108 GLENDALE BLVD # 489
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-1806
Practice Address - Country:US
Practice Address - Phone:323-546-7652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA131638106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist