Healthcare Provider Details

I. General information

NPI: 1992350102
Provider Name (Legal Business Name): LIDIA MARIA ANAYA ROMAN AMFT, ALPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2019
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 W LA VETA AVE STE 260
ORANGE CA
92868-4439
US

IV. Provider business mailing address

1430 CABRILLO PARK DR APT F
SANTA ANA CA
92701-2860
US

V. Phone/Fax

Practice location:
  • Phone: 714-771-8006
  • Fax: 714-744-8630
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number146048
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: