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General NPI Number Information
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NPI Number | 1710171830
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Entity Type | Individual
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Provider Name | LISA J NIINO M.A., LMFT
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Gender | Female
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Dates
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Enumeration Date | 08/31/2007
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 23421 S POINTE DR STE 290
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-1555
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Country | US
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Telephone | 888-688-0248
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Fax |
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Provider Business Mailing Address
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Address Line | 360 E 1ST ST # 135
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City | TUSTIN
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State | CA
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Zip | 92780-3211
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Country | US
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Telephone | 714-321-9311
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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 | 45405
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License Number State | CA
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