Healthcare Provider Details

I. General information

NPI: 1386552875
Provider Name (Legal Business Name): MELANIE LANE BOMAR LMFT, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25500 HAWTHORNE BLVD STE 1030
TORRANCE CA
90505-6837
US

IV. Provider business mailing address

235 W HILLSDALE ST
INGLEWOOD CA
90302-1119
US

V. Phone/Fax

Practice location:
  • Phone: 424-261-0576
  • Fax:
Mailing address:
  • Phone: 310-621-8738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9773
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number121603
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: