Provider Demographics
NPI:1396932562
Name:KLUDT, CYNTHIA (LMFT)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:KLUDT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:KLUDT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:12302 HERBERT ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-4915
Mailing Address - Country:US
Mailing Address - Phone:310-890-9831
Mailing Address - Fax:310-398-4559
Practice Address - Street 1:12302 HERBERT ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-4915
Practice Address - Country:US
Practice Address - Phone:310-890-9831
Practice Address - Fax:310-398-4559
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2013-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC17409106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist