Healthcare Provider Details

I. General information

NPI: 1144144650
Provider Name (Legal Business Name): LAURA LYNNE AMABISCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 W SUNSET BLVD
LOS ANGELES CA
90027-6070
US

IV. Provider business mailing address

19141 GOLDEN VALLEY RD # 1153
SANTA CLARITA CA
91387-1428
US

V. Phone/Fax

Practice location:
  • Phone: 323-783-2600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number134990
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: