Provider Demographics
NPI:1306274550
Name:KERR, LUDMILLA (PSYD)
Entity type:Individual
Prefix:
First Name:LUDMILLA
Middle Name:
Last Name:KERR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:LYUDMILA
Other - Middle Name:V
Other - Last Name:ALEKSANDROVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1114 22ND ST APT 1
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403
Mailing Address - Country:US
Mailing Address - Phone:310-806-3129
Mailing Address - Fax:
Practice Address - Street 1:1114 22ND ST APT 1
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403
Practice Address - Country:US
Practice Address - Phone:310-806-3129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-25
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 51572106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist