Provider Demographics
NPI:1184261562
Name:WOLFE, DAVID BRIAN (PHD LMFT 18137)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRIAN
Last Name:WOLFE
Suffix:
Gender:M
Credentials:PHD LMFT 18137
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 S SHERBOURNE DR APT 4
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-2332
Mailing Address - Country:US
Mailing Address - Phone:323-394-6283
Mailing Address - Fax:
Practice Address - Street 1:822 S ROBERTSON BLVD STE 303
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-1632
Practice Address - Country:US
Practice Address - Phone:323-394-6283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106173106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist