Provider Demographics
NPI:1376204776
Name:EBBE-WHEELER, LAURA ANN (LMFT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:EBBE-WHEELER
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:PO BOX 39575
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-0575
Mailing Address - Country:US
Mailing Address - Phone:213-926-9531
Mailing Address - Fax:
Practice Address - Street 1:427 S LA PEER DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3503
Practice Address - Country:US
Practice Address - Phone:323-417-7657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-07
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA130265106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist