Provider Demographics
NPI:1982048930
Name:MCCARRAHER-WETZEL, ANN PATRICIA (LMFT)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:PATRICIA
Last Name:MCCARRAHER-WETZEL
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 1:5290 LA CANADA BLVD
Mailing Address - Street 2:
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-1722
Mailing Address - Country:US
Mailing Address - Phone:818-952-1328
Mailing Address - Fax:
Practice Address - Street 1:5290 LA CANADA BLVD
Practice Address - Street 2:
Practice Address - City:LA CANADA
Practice Address - State:CA
Practice Address - Zip Code:91011-1722
Practice Address - Country:US
Practice Address - Phone:818-952-1328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52119106H00000X
CA11961225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist