Provider Demographics
NPI:1912115882
Name:IANNI, LYNN ELIZABETH (PHD, MFT)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:ELIZABETH
Last Name:IANNI
Suffix:
Gender:F
Credentials:PHD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2829 BOTTLEBRUSH DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-2011
Mailing Address - Country:US
Mailing Address - Phone:310-470-0234
Mailing Address - Fax:
Practice Address - Street 1:2829 BOTTLEBRUSH DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90077-2011
Practice Address - Country:US
Practice Address - Phone:310-470-0234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC21521106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist