Healthcare Provider Details

I. General information

NPI: 1306100649
Provider Name (Legal Business Name): KAMBRIA CALDWELL LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2012
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 N PACIFIC COAST HWY STE 2000
EL SEGUNDO CA
90245-5614
US

IV. Provider business mailing address

222 N PACIFIC COAST HWY STE 2000
EL SEGUNDO CA
90245-5614
US

V. Phone/Fax

Practice location:
  • Phone: 424-261-9368
  • Fax:
Mailing address:
  • Phone: 424-261-9368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2610-R
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number88546
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: