Healthcare Provider Details

I. General information

NPI: 1275969883
Provider Name (Legal Business Name): MARY ARROYO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2013
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E CHAPMAN AVE
FULLERTON CA
92831-3839
US

IV. Provider business mailing address

801 E CHAPMAN AVE STE 101
FULLERTON CA
92831-3841
US

V. Phone/Fax

Practice location:
  • Phone: 714-680-9000
  • Fax:
Mailing address:
  • Phone: 714-680-9000
  • Fax: 714-680-9081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: