Provider Demographics
NPI:1245362052
Name:JUDI CANTOR MA MFT
Entity type:Organization
Organization Name:JUDI CANTOR MA MFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MFT
Authorized Official - Prefix:
Authorized Official - First Name:JUDI
Authorized Official - Middle Name:
Authorized Official - Last Name:CANTOR
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:661-260-3114
Mailing Address - Street 1:25350 MAGIC MOUNTAIN PKWY
Mailing Address - Street 2:SUITE 170
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1151
Mailing Address - Country:US
Mailing Address - Phone:661-260-3114
Mailing Address - Fax:661-253-3757
Practice Address - Street 1:25350 MAGIC MOUNTAIN PKWY
Practice Address - Street 2:SUITE 170
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1151
Practice Address - Country:US
Practice Address - Phone:661-260-3114
Practice Address - Fax:661-253-3757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35006106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty