Healthcare Provider Details

I. General information

NPI: 1962050617
Provider Name (Legal Business Name): LAUREN PIETRA MA, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2019
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1961 W. HUNTINGTON DR. SUITE 204
SOUTH PASADENA CA
91030
US

IV. Provider business mailing address

1551 COLORADO BLVD STE 201
LOS ANGELES CA
90041-1496
US

V. Phone/Fax

Practice location:
  • Phone: 323-680-4225
  • Fax:
Mailing address:
  • Phone: 213-378-7756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT138388
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAMFT114197
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMFT138388
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: