Provider Demographics
NPI:1104632983
Name:BOYCE, ROSEMARY LOTUS (AMFT)
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:LOTUS
Last Name:BOYCE
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 3/4 CARMONA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016-1116
Mailing Address - Country:US
Mailing Address - Phone:917-444-6485
Mailing Address - Fax:
Practice Address - Street 1:11835 W OLYMPIC BLVD STE 815E
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-5056
Practice Address - Country:US
Practice Address - Phone:213-433-5871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA150037106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist