Provider Demographics
NPI:1265180335
Name:SPEARS-TAKAKUWA, ZOE MAHEALANI (LMFT)
Entity type:Individual
Prefix:
First Name:ZOE
Middle Name:MAHEALANI
Last Name:SPEARS-TAKAKUWA
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 1:12340 SANTA MONICA BLVD STE 214
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-2594
Mailing Address - Country:US
Mailing Address - Phone:310-582-1513
Mailing Address - Fax:
Practice Address - Street 1:12340 SANTA MONICA BLVD STE 214
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-2594
Practice Address - Country:US
Practice Address - Phone:310-582-1513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-16
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA118502106H00000X
137699106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist