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General NPI Number Information
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NPI Number | 1356761662
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Entity Type | Individual
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Provider Name | RENEE GERRIEL DITTA LMFT
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Gender | Female
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Dates
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Enumeration Date | 04/25/2014
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Last Update Date | 08/13/2024
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Provider Practice Location Address
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Address Line | 20776 COTTONWOOD RD
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City | YORBA LINDA
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State | CA
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Zip | 92887-3311
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Country | US
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Telephone | 818-807-5534
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Fax |
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Provider Business Mailing Address
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Address Line | 20409 YORBA LINDA BLVD SUITE K-2 #219
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City | YORBA LINDA
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State | CA
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Zip | 92886
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Country | US
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Telephone | 818-588-5444
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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 | 93478
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License Number State | CA
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