Provider Demographics
NPI:1184907578
Name:COHEN, JUDITH SUE (MFC)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:SUE
Last Name:COHEN
Suffix:
Gender:F
Credentials:MFC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32123 LINDERO CYN
Mailing Address - Street 2:STE 201
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-4204
Mailing Address - Country:US
Mailing Address - Phone:310-890-9488
Mailing Address - Fax:
Practice Address - Street 1:32123 LINDERO CANYON RD
Practice Address - Street 2:STE 201
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-4204
Practice Address - Country:US
Practice Address - Phone:310-890-9488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC23359106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist