1326330556 NPI number — MS. LETICIA ALEXA THURMAN M.A., LMFT

Table of content: MS. LETICIA ALEXA THURMAN M.A., LMFT (NPI 1326330556)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326330556 NPI number — MS. LETICIA ALEXA THURMAN M.A., LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THURMAN
Provider First Name:
LETICIA
Provider Middle Name:
ALEXA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.A., LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ARELLANO-BELLOC
Provider Other First Name:
LETICIA
Provider Other Middle Name:
ALEXA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.A.,MFTI
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1326330556
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/22/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1187 COAST VILLAGE RD
Provider Second Line Business Mailing Address:
SUITE 268
Provider Business Mailing Address City Name:
SANTA BARBARA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93108-2737
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-288-3188
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
152 S LASKY DR
Provider Second Line Business Practice Location Address:
SUITE 208
Provider Business Practice Location Address City Name:
BEVERLY HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90212-1720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-288-3188
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/05/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  91329 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)