Provider Demographics
NPI:1063523447
Name:PAPPOFF, JUDITH SCANLON (LMFT)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:SCANLON
Last Name:PAPPOFF
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:AS
Other - Last Name:PAPPOFF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:17612 BEACH BLVD
Mailing Address - Street 2:3B
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-6873
Mailing Address - Country:US
Mailing Address - Phone:714-843-2621
Mailing Address - Fax:714-843-2621
Practice Address - Street 1:17612 BEACH BLVD
Practice Address - Street 2:3B
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-6873
Practice Address - Country:US
Practice Address - Phone:714-843-2621
Practice Address - Fax:714-843-2621
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC22399106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist