Healthcare Provider Details

I. General information

NPI: 1982019352
Provider Name (Legal Business Name): MICHAEL MAZZARINO LMFT, LAADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2014
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5150 E PACIFIC COAST HWY STE 200
LONG BEACH CA
90804-3399
US

IV. Provider business mailing address

5150 E PACIFIC COAST HWY STE 200
LONG BEACH CA
90804-3399
US

V. Phone/Fax

Practice location:
  • Phone: 562-335-9497
  • Fax: 657-339-3050
Mailing address:
  • Phone: 562-335-9497
  • Fax: 657-339-3050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number102259
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: