Healthcare Provider Details

I. General information

NPI: 1982913976
Provider Name (Legal Business Name): YVETTE CONCETTA THOMAS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2010
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 THE CITY DR S
ORANGE CA
92868-3205
US

IV. Provider business mailing address

23173 LA CADENA DR
LAGUNA HILLS CA
92653-1404
US

V. Phone/Fax

Practice location:
  • Phone: 714-794-5414
  • Fax:
Mailing address:
  • Phone: 714-794-5414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number71033
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number116432
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: