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General NPI Number Information
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NPI Number | 1164371019
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Entity Type | Individual
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Provider Name | ANDREA PENALOZA AMFT, APCC
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Gender | Female
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Dates
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Enumeration Date | 01/23/2026
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 31371 RANCHO VIEJO RD STE 203
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-1849
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Country | US
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Telephone | 404-391-7992
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Fax |
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Provider Business Mailing Address
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Address Line | 32066 PASEO ROCA
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-2750
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Country | US
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Telephone | 404-391-7992
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | AMFT157585
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License Number State | CA
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