Provider Demographics
NPI:1912659632
Name:TERMINI, CALISTA ATHENA (LMFT)
Entity type:Individual
Prefix:MS
First Name:CALISTA
Middle Name:ATHENA
Last Name:TERMINI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22287 MULHOLLAND HWY # 179
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-5157
Mailing Address - Country:US
Mailing Address - Phone:310-929-0134
Mailing Address - Fax:
Practice Address - Street 1:22287 MULHOLLAND HWY # 179
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-5157
Practice Address - Country:US
Practice Address - Phone:310-929-0134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-24
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA148917106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALMFT148917OtherCALIFORNIA BOARD OF BEHAVIORAL SCIENCES