Provider Demographics
NPI:1124671425
Name:HORWITZ, KAMALA MARIE (MA)
Entity type:Individual
Prefix:
First Name:KAMALA
Middle Name:MARIE
Last Name:HORWITZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 PACIFIC COAST HIGHWAY
Mailing Address - Street 2:SUITE 214
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254
Mailing Address - Country:US
Mailing Address - Phone:424-241-0422
Mailing Address - Fax:
Practice Address - Street 1:2200 PACIFIC COAST HIGHWAY
Practice Address - Street 2:SUITE 214
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254
Practice Address - Country:US
Practice Address - Phone:424-241-0422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT109470106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist