Healthcare Provider Details

I. General information

NPI: 1033720818
Provider Name (Legal Business Name): MICHELLE T VOLZ LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2020
Last Update Date: 08/13/2020
Certification Date: 08/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24881 ALICIA PKWY # E-223
LAGUNA HILLS CA
92653-4617
US

IV. Provider business mailing address

24000 ALICIA PKWY UNIT 17-203
MISSION VIEJO CA
92691-3929
US

V. Phone/Fax

Practice location:
  • Phone: 949-445-3855
  • Fax:
Mailing address:
  • Phone: 949-528-2956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT31265
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: