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General NPI Number Information
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NPI Number | 1013313386
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Entity Type | Individual
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Provider Name | MARISA LEPORE LMFT
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Gender | Female
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Dates
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Enumeration Date | 11/13/2014
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Last Update Date | 10/21/2021
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Provider Practice Location Address
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Address Line | 19742 MACARTHUR BLVD STE 235
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City | IRVINE
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State | CA
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Zip | 92612-2446
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Country | US
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Telephone | 949-306-3368
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Fax | 949-305-4567
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Provider Business Mailing Address
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Address Line | 23411 SUMMERFIELD #12-G
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City | ALISO VIEJO
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State | CA
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Zip | 92656-4814
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Country | US
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Telephone | 949-306-3368
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Fax | 949-305-4567
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC43560
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License Number State | CA
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