Healthcare Provider Details

I. General information

NPI: 1528576469
Provider Name (Legal Business Name): PABLO DELA CRUZ LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2018
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 THE CITY DR S FL 2
ORANGE CA
92868-3205
US

IV. Provider business mailing address

1439 W CHAPMAN AVE # 164
ORANGE CA
92868-2738
US

V. Phone/Fax

Practice location:
  • Phone: 714-935-6363
  • Fax:
Mailing address:
  • Phone: 714-721-9805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT159082
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: