Healthcare Provider Details

I. General information

NPI: 1992613764
Provider Name (Legal Business Name): FRED LABUNIKHER M.A., APCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4859 W SLAUSON AVE # 469
LOS ANGELES CA
90056-1290
US

IV. Provider business mailing address

4325 GLENCOE AVE STE C9
MARINA DEL REY CA
90292-6444
US

V. Phone/Fax

Practice location:
  • Phone: 424-228-8994
  • Fax:
Mailing address:
  • Phone: 424-228-8994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC23062
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: