Healthcare Provider Details

I. General information

NPI: 1831491224
Provider Name (Legal Business Name): MRS. ALAINA M EAMES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2010
Last Update Date: 03/21/2022
Certification Date: 03/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 W MAIN ST STE 202
TUSTIN CA
92780-7703
US

IV. Provider business mailing address

210 W MAIN ST STE 202
TUSTIN CA
92780-7703
US

V. Phone/Fax

Practice location:
  • Phone: 949-413-2698
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number88582
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: