Healthcare Provider Details

I. General information

NPI: 1821671538
Provider Name (Legal Business Name): MICHELLE J HOWARD LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2021
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13157 MINDANAO WAY # 429
MARINA DEL REY CA
90292-6307
US

IV. Provider business mailing address

13157 MINDANAO WAY # 429
MARINA DEL REY CA
90292-6307
US

V. Phone/Fax

Practice location:
  • Phone: 424-248-7772
  • Fax:
Mailing address:
  • Phone: 424-248-7772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number125119
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: