Healthcare Provider Details

I. General information

NPI: 1629003421
Provider Name (Legal Business Name): WAYNE PHILIP LENZ LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5816 CORPORATE AVE STE 170
CYPRESS CA
90630-4736
US

IV. Provider business mailing address

4300 ROSE DR
YORBA LINDA CA
92886-2026
US

V. Phone/Fax

Practice location:
  • Phone: 714-269-2053
  • Fax:
Mailing address:
  • Phone: 714-269-2053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT35899
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: