Healthcare Provider Details

I. General information

NPI: 1669535621
Provider Name (Legal Business Name): MARIA DAWN AUSTIN MMFT, PSY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18221 E 17TH ST
SANTA ANA CA
92705-2676
US

IV. Provider business mailing address

18221 E 17TH ST
SANTA ANA CA
92705-2676
US

V. Phone/Fax

Practice location:
  • Phone: 657-966-1500
  • Fax:
Mailing address:
  • Phone: 657-966-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number33367
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: