Healthcare Provider Details

I. General information

NPI: 1750736617
Provider Name (Legal Business Name): CYNTHIA KAHL LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2016
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 W METROPOLITAN DR STE 120
ORANGE CA
92868-3504
US

IV. Provider business mailing address

35 PRAIRIE FALCON
ALISO VIEJO CA
92656-1718
US

V. Phone/Fax

Practice location:
  • Phone: 714-972-3700
  • Fax:
Mailing address:
  • Phone: 949-290-3207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1143441
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: