Healthcare Provider Details

I. General information

NPI: 1265131395
Provider Name (Legal Business Name): LAURA PEREZ FLORES LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2023
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5550 GROSVENOR BLVD
LOS ANGELES CA
90066-6999
US

IV. Provider business mailing address

5550 GROSVENOR BLVD APT 323
LOS ANGELES CA
90066-7318
US

V. Phone/Fax

Practice location:
  • Phone: 310-486-1657
  • Fax:
Mailing address:
  • Phone: 310-429-4720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT162442
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: