MEDICARE: JUDI CRAVEN LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	40014	CA

General Provider Information

NPI Number	:	1144057472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDI CRAVEN LMFT

Provider Business Mailing Address
First Line	:	2408 STOW ST
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063-3558
Country	:	US
Telephone Number	:	818-383-8165
Fax Number	:

Provider Business Practice Location Address
First Line	:	2408 STOW ST
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063-3558
Country	:	US
Telephone Number	:	818-383-8165
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2024
Last Update Date	:	09/19/2024

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Directions to “ JUDI CRAVEN LMFT” Practice Location

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