Laura Bustamante

Individual provider Active NPI Marriage & Family Therapist · Pico Rivera, CA

NPI 1679356752 · NPPES record last updated Mar 14, 2024

Key facts

NPI
1679356752
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
AMFT145768 (CA)
Practice address
8337 Telegraph Rd Ste 300
Pico Rivera, CA 90660-4957
Phone
(562) 865-3644
NPI assigned
Aug 14, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
APCC15874CAMDProfessional Counselor
AMFT145768CAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X APCC15874 CA
Marriage & Family Therapist 106H00000X
Marriage & Family Therapist 106H00000X AMFT145768 CA Yes

Addresses

Primary practice location

8337 Telegraph Rd Ste 300
Pico Rivera, CA 90660-4957

Mailing address

5030 E Woodwind LN
Anaheim, CA 92807-1145
Phone (323) 420-7656

Other providers in Pico Rivera, CA

All providers in Pico Rivera, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.