Provider Demographics
NPI:1740489178
Name:DUNNE, WENDY LABOV (LMFT)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:LABOV
Last Name:DUNNE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:LABOV-DUNNE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:18 WOOD LN
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:CA
Mailing Address - Zip Code:94930-2016
Mailing Address - Country:US
Mailing Address - Phone:415-488-5591
Mailing Address - Fax:
Practice Address - Street 1:1368 LINCOLN AVE STE 108
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901
Practice Address - Country:US
Practice Address - Phone:415-488-5591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2018-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT52695106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1455000OtherPARTNERSHIP OF CALIFORNIA