Healthcare Provider Details

I. General information

NPI: 1134240112
Provider Name (Legal Business Name): ELIZABETH ORRAS MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23521 PASEO DE VALENCIA 206A
LAGUNA HILLS CA
92653-3107
US

IV. Provider business mailing address

151 KALMUS DR K-1
COSTA MESA CA
92626-5988
US

V. Phone/Fax

Practice location:
  • Phone: 949-768-6845
  • Fax: 949-768-5124
Mailing address:
  • Phone: 714-384-3870
  • Fax: 714-384-3875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC29193
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: