Provider Demographics
NPI:1992096994
Name:WILLINGHAM, MARIAN ANDREA (LMFT)
Entity type:Individual
Prefix:MS
First Name:MARIAN
Middle Name:ANDREA
Last Name:WILLINGHAM
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:POB 52
Mailing Address - Street 2:
Mailing Address - City:CAMBRIA
Mailing Address - State:CA
Mailing Address - Zip Code:93428
Mailing Address - Country:US
Mailing Address - Phone:805-909-2057
Mailing Address - Fax:805-927-8150
Practice Address - Street 1:910 HARTFORD ST
Practice Address - Street 2:
Practice Address - City:CAMBRIA
Practice Address - State:CA
Practice Address - Zip Code:93428
Practice Address - Country:US
Practice Address - Phone:805-909-2057
Practice Address - Fax:805-927-8150
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC45738106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist