Healthcare Provider Details

I. General information

NPI: 1346549375
Provider Name (Legal Business Name): ADRIANA NIIZAWA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2011
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3420 BRISTOL ST STE 600
COSTA MESA CA
92626-7133
US

IV. Provider business mailing address

1932 E DEERE AVE STE 240
SANTA ANA CA
92705-5716
US

V. Phone/Fax

Practice location:
  • Phone: 949-866-5493
  • Fax:
Mailing address:
  • Phone: 714-543-4333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number89887
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: