Healthcare Provider Details

I. General information

NPI: 1235851064
Provider Name (Legal Business Name): LIEZEL LAUGUICO LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30941 AGOURA RD STE 210
WESTLAKE VILLAGE CA
91361-4658
US

IV. Provider business mailing address

30941 AGOURA RD STE 210
WESTLAKE VILLAGE CA
91361-4658
US

V. Phone/Fax

Practice location:
  • Phone: 805-243-8903
  • Fax:
Mailing address:
  • Phone: 805-243-8903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number152652
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: