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General NPI Number Information
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NPI Number | 1548881154
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Entity Type | Individual
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Provider Name | AMY JUAREZ LUCIO LMFT, LPCC
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Gender | Female
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Dates
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Enumeration Date | 05/05/2020
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Last Update Date | 06/29/2021
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Provider Practice Location Address
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Address Line | 401 W CIVIC CENTER DR
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City | SANTA ANA
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State | CA
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Zip | 92701-4515
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Country | US
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Telephone | 714-568-5610
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Fax |
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Provider Business Mailing Address
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Address Line | 24322 SAGE CT
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-6292
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Country | US
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Telephone | 949-403-0913
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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 | LMFT110580
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License Number State | CA
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