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General NPI Number Information
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NPI Number | 1063952141
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Entity Type | Individual
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Provider Name | TODD OLTHOFF LMFT
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Gender | Male
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Dates
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Enumeration Date | 03/08/2017
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Last Update Date | 04/25/2018
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Provider Practice Location Address
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Address Line | 27001 LA PAZ RD SUITE 300B
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City | MISSION VIEJO
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State | CA
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Zip | 92691-5502
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Country | US
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Telephone | 949-872-3243
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Fax |
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Provider Business Mailing Address
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Address Line | 26131 MARGUERITE PKWY STE A
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City | MISSION VIEJO
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State | CA
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Zip | 92692-3161
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Country | US
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Telephone | 949-872-3243
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Fax |
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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 | 98629
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License Number State | CA
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