Healthcare Provider Details

I. General information

NPI: 1508062936
Provider Name (Legal Business Name): MARGARET ANN POOL LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 CANYON CREST DR STE 103
RIVERSIDE CA
92507-6353
US

IV. Provider business mailing address

32662 ALTA PINE LN
SAN JUAN CAPISTRANO CA
92675-4334
US

V. Phone/Fax

Practice location:
  • Phone: 951-248-4000
  • Fax: 951-248-4049
Mailing address:
  • Phone: 949-981-5409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC34647
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: