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General NPI Number Information
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NPI Number | 1427650506
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Entity Type | Individual
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Provider Name | CAROLINE EZZAT MOUNIR HANNA MFT
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Gender | Female
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Dates
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Enumeration Date | 11/12/2020
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Last Update Date | 02/15/2024
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Provider Practice Location Address
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Address Line | 5 MAREBLU
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City | ALISO VIEJO
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State | CA
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Zip | 92656-3014
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Country | US
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Telephone | 949-643-6941
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Fax |
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Provider Business Mailing Address
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Address Line | 118 ENCANTADO CYN
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688-4973
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Country | US
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Telephone | 714-829-9592
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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 | 143838
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License Number State | CA
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