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General NPI Number Information
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NPI Number | 1164950747
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Entity Type | Organization
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Legal Business Name | COUNSELING-BY-DEANN
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Dates
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Enumeration Date | 05/26/2017
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Last Update Date | 05/26/2017
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Provider Practice Location Address
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Address Line | 601 E YORBA LINDA BLVD STE 2
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City | PLACENTIA
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State | CA
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Zip | 92870-3006
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Country | US
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Telephone | 714-705-6850
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Fax | 714-773-4797
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Provider Business Mailing Address
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Address Line | 1952 SMOKEWOOD AVE
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City | FULLERTON
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State | CA
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Zip | 92831-1034
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Country | US
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Telephone | 714-773-4797
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Fax | 714-773-4797
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JESSE M RICHTER
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Credential |
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Telephone | 714-773-4797
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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 | 38219
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License Number State | CA
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