Provider Demographics
NPI:1841830718
Name:VAUGHN-MUNEMITSU, STISHA (LMFT)
Entity type:Individual
Prefix:MRS
First Name:STISHA
Middle Name:
Last Name:VAUGHN-MUNEMITSU
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:STISHA
Other - Middle Name:
Other - Last Name:VAUGHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6206 BECKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-6634
Mailing Address - Country:US
Mailing Address - Phone:818-538-4551
Mailing Address - Fax:
Practice Address - Street 1:6206 BECKFORD AVE
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91335-6634
Practice Address - Country:US
Practice Address - Phone:818-538-4551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90766106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist