Healthcare Provider Details

I. General information

NPI: 1831697507
Provider Name (Legal Business Name): ANSTISS MARIE PEREZ LMFT, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANSTISS MARIE EATON

II. Dates (important events)

Enumeration Date: 01/29/2018
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15635 ALTON PKWY STE 350
IRVINE CA
92618-7333
US

IV. Provider business mailing address

15635 ALTON PKWY STE 350
IRVINE CA
92618-7333
US

V. Phone/Fax

Practice location:
  • Phone: 949-528-6300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPCC20949
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT154274
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: