Provider Demographics
NPI:1710181573
Name:VIERRA, EMILY A (LMFT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:A
Last Name:VIERRA
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 1:2421 MARSHALLFIELD LN UNIT 3
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-4460
Mailing Address - Country:US
Mailing Address - Phone:209-814-6755
Mailing Address - Fax:
Practice Address - Street 1:9101 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-2405
Practice Address - Country:US
Practice Address - Phone:562-801-4626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50354106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist