Healthcare Provider Details

I. General information

NPI: 1588195143
Provider Name (Legal Business Name): BIANCA RANNEY ED.D., LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2017
Last Update Date: 03/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 S EASTERN AVE STE 551
COMMERCE CA
90040-4016
US

IV. Provider business mailing address

5800 S EASTERN AVE STE 551
COMMERCE CA
90040-4016
US

V. Phone/Fax

Practice location:
  • Phone: 714-623-9171
  • Fax: 714-908-8383
Mailing address:
  • Phone: 714-623-9171
  • Fax: 714-908-8383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number98453
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: