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General NPI Number Information
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NPI Number | 1831980978
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Entity Type | Organization
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Legal Business Name | LAURA A BLOOMBERG LMFT
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Dates
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Enumeration Date | 05/16/2025
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 322 CANYON CREST LN
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City | LAKE ARROWHEAD
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State | CA
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Zip | 92352
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Country | US
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Telephone | 424-262-3525
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Fax |
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Provider Business Mailing Address
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Address Line | 28982 HOOK CREEK RD # 481
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City | CEDAR GLEN
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State | CA
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Zip | 92321-0400
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Country | US
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Telephone | 310-382-0596
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | LAURA A BLOOMBERG
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Credential | LMFT
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Telephone | 310-382-0596
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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