Healthcare Provider Details

I. General information

NPI: 1760962864
Provider Name (Legal Business Name): LYNN MARIE FARRELL LICENSED MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. LYNN MARIE LUNDQUIST

II. Dates (important events)

Enumeration Date: 08/17/2018
Last Update Date: 03/08/2026
Certification Date: 03/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

742 E CHAPMAN AVE
ORANGE CA
92866-1621
US

IV. Provider business mailing address

742 E CHAPMAN AVE
ORANGE CA
92866-1621
US

V. Phone/Fax

Practice location:
  • Phone: 714-293-6573
  • Fax: 714-333-4972
Mailing address:
  • Phone: 714-293-6573
  • Fax: 714-333-4972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number79804
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number110061
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: