MEDICARE: MAYRA INIGUEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1467858266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAYRA INIGUEZ

Provider Business Mailing Address
First Line	:	1651 E 4TH ST STE 211
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92701-5142
Country	:	US
Telephone Number	:	657-999-0052
Fax Number	:

Provider Business Practice Location Address
First Line	:	1651 E 4TH ST
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92701-5164
Country	:	US
Telephone Number	:	657-999-0052
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2014
Last Update Date	:	03/03/2023

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Directions to “ MAYRA INIGUEZ ” Practice Location

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