Healthcare Provider Details

I. General information

NPI: 1831624360
Provider Name (Legal Business Name): MURIEL CASAMAYOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2017
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

242 W MAIN ST STE 104
TUSTIN CA
92780-7715
US

IV. Provider business mailing address

242 W MAIN ST STE 104
TUSTIN CA
92780-7715
US

V. Phone/Fax

Practice location:
  • Phone: 714-681-0052
  • Fax:
Mailing address:
  • Phone: 714-681-0052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT116554
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMF98506
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: