Healthcare Provider Details

I. General information

NPI: 1932627262
Provider Name (Legal Business Name): ANNA MARIE MCNERNEY AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2017
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6736 LAUREL CANYON BLVD STE 200
NORTH HOLLYWOOD CA
91606
US

IV. Provider business mailing address

224 W DRYDEN ST APT 313
GLENDALE CA
91202-3743
US

V. Phone/Fax

Practice location:
  • Phone: 818-755-8784
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number107215
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: