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Organization
LAKESIDE FAMILY COUNSELING & INTERVENTION SERVICES
Active
Organization
LAKESIDE FAMILY COUNSELING & INTERVENTION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI RENEE JOHNSON LMFT (PRESIDENT)
(805) 575-2559
Entity
Organization
Contact information
Practice address
1500 PALMA DR, VENTURA, CA 93003-6451
(805) 289-1500
(805) 289-1511
Mailing address
1500 PALMA DR, VENTURA, CA 93003-6451
(805) 289-1500
(805) 289-1511
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
108676
CA
Other
Enumeration date
09/09/2018
Last updated
09/28/2019
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