Provider Demographics
NPI:1326443177
Name:LANDAU, AUBREY
Entity type:Individual
Prefix:MS
First Name:AUBREY
Middle Name:
Last Name:LANDAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 BELLE VIEW BLVD # 3611
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22307-6530
Mailing Address - Country:US
Mailing Address - Phone:619-693-4945
Mailing Address - Fax:
Practice Address - Street 1:1520 BELLE VIEW BLVD # 3611
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22307-6530
Practice Address - Country:US
Practice Address - Phone:619-693-4945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-22
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717002316106H00000X
CA97502106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7667OtherMEDI-CAL
CA7184OtherMEDI-CAL
CA7368OtherMEDI-CAL
CA7708OtherMEDI-CAL