Provider Demographics
NPI:1255966776
Name:RICE, PAMELA ANN (LMFT)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:RICE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6606 1/2 W OLYMPIC BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5359
Mailing Address - Country:US
Mailing Address - Phone:323-272-3605
Mailing Address - Fax:323-272-4087
Practice Address - Street 1:6606 1/2 W OLYMPIC BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5359
Practice Address - Country:US
Practice Address - Phone:323-272-3605
Practice Address - Fax:323-272-4087
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT36466106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty