Provider Demographics
NPI:1831980978
Name:LAURA A BLOOMBERG LMFT
Entity type:Organization
Organization Name:LAURA A BLOOMBERG LMFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BLOOMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:310-382-0596
Mailing Address - Street 1:28982 HOOK CREEK RD # 481
Mailing Address - Street 2:
Mailing Address - City:CEDAR GLEN
Mailing Address - State:CA
Mailing Address - Zip Code:92321-0400
Mailing Address - Country:US
Mailing Address - Phone:310-382-0596
Mailing Address - Fax:
Practice Address - Street 1:322 CANYON CREST LN
Practice Address - Street 2:
Practice Address - City:LAKE ARROWHEAD
Practice Address - State:CA
Practice Address - Zip Code:92352
Practice Address - Country:US
Practice Address - Phone:424-262-3525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty