Provider Demographics
NPI:1528262086
Name:PERKINS, ANNE MARIE (MFTI)
Entity type:Individual
Prefix:MRS
First Name:ANNE MARIE
Middle Name:
Last Name:PERKINS
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5893 1/2 DOVERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-7203
Mailing Address - Country:US
Mailing Address - Phone:310-774-1741
Mailing Address - Fax:
Practice Address - Street 1:2040 S BEDFORD ST APT 4
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-1252
Practice Address - Country:US
Practice Address - Phone:310-774-1741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67607101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health