Provider Demographics
NPI:1982254561
Name:EKUM, EMMA (LMFT)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:EKUM
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:
Other - Last Name:JAEGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:18034 VENTURA BLVD #732
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316
Mailing Address - Country:US
Mailing Address - Phone:818-732-0025
Mailing Address - Fax:
Practice Address - Street 1:18034 VENTURA BLVD #732
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316
Practice Address - Country:US
Practice Address - Phone:818-732-0025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-16
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT71907106H00000X
CA111175106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty