Healthcare Provider Details

I. General information

NPI: 1770822280
Provider Name (Legal Business Name): LORITA CASANOVA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2013
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 ENTERPRISE WAY
MODESTO CA
95356
US

IV. Provider business mailing address

PO BOX 2087
MERCED CA
95344-0087
US

V. Phone/Fax

Practice location:
  • Phone: 209-550-6034
  • Fax:
Mailing address:
  • Phone: 209-381-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMFT132421
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: