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General NPI Number Information
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NPI Number | 1437240918
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Entity Type | Individual
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Provider Name | DEBBIE LYNN MIRANDA-BRISTOL LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 06/01/2018
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Provider Practice Location Address
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Address Line | 680 LANGSDORF DR STE 219
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City | FULLERTON
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State | CA
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Zip | 92831
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Country | US
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Telephone | 714-543-6720
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Fax | 714-519-3849
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Provider Business Mailing Address
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Address Line | 900 MELODY LN
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City | FULLERTON
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State | CA
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Zip | 92831-1956
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Country | US
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Telephone | 714-543-6720
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Fax | 714-519-3849
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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 | LMFT 22036
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License Number State | CA
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