Provider Demographics
NPI:1699291476
Name:PERRY-BURKHARDT, VONNE HONG (LMFT)
Entity type:Individual
Prefix:
First Name:VONNE
Middle Name:HONG
Last Name:PERRY-BURKHARDT
Suffix:
Gender:U
Credentials:LMFT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:YVONNE
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:708 N EUCALYPTUS AVE APT 109
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302-3631
Mailing Address - Country:US
Mailing Address - Phone:323-741-1561
Mailing Address - Fax:323-948-0443
Practice Address - Street 1:708 N EUCALYPTUS AVE APT 109
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-3631
Practice Address - Country:US
Practice Address - Phone:323-741-1561
Practice Address - Fax:323-948-0443
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-14
Last Update Date:2024-04-17
Deactivation Date:2023-01-10
Deactivation Code:
Reactivation Date:2023-02-13
Provider Licenses
StateLicense IDTaxonomies
CALMFT119458106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist