Healthcare Provider Details

I. General information

NPI: 1205755360
Provider Name (Legal Business Name): LIGHT WITHIN MARRIAGE AND FAMILY THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8251 WESTMINSTER BLVD STE 202
WESTMINSTER CA
92683-3370
US

IV. Provider business mailing address

8251 WESTMINSTER BLVD STE 202
WESTMINSTER CA
92683-3370
US

V. Phone/Fax

Practice location:
  • Phone: 714-261-9953
  • Fax:
Mailing address:
  • Phone: 714-261-9953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ATHENA DAO
Title or Position: OWNER
Credential:
Phone: 714-261-9953