Provider Demographics
NPI:1457728859
Name:KANSTEINER, LAURA JANE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:JANE
Last Name:KANSTEINER
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 4157
Mailing Address - Street 2:
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90264-4157
Mailing Address - Country:US
Mailing Address - Phone:310-924-5921
Mailing Address - Fax:
Practice Address - Street 1:28310 ROADSIDE DR
Practice Address - Street 2:SUITE 235
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-4923
Practice Address - Country:US
Practice Address - Phone:818-852-7077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT50406101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health