Provider Demographics
NPI:1861714487
Name:BLACKSHER, DEYANA MOTEN (MA, LMFT)
Entity type:Individual
Prefix:MRS
First Name:DEYANA
Middle Name:MOTEN
Last Name:BLACKSHER
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8939 S SEPULVEDA BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-3648
Mailing Address - Country:US
Mailing Address - Phone:310-422-2192
Mailing Address - Fax:
Practice Address - Street 1:8939 S SEPULVEDA BLVD STE 230
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-3648
Practice Address - Country:US
Practice Address - Phone:310-422-2192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 48074106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist