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General NPI Number Information
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NPI Number | 1760770655
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Entity Type | Individual
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Provider Name | LAUREN FUNIESTAS LMFT #121004
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Gender | Female
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Dates
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Enumeration Date | 07/13/2011
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 2051 JOHN JONES RD
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City | DAVIS
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State | CA
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Zip | 95616-9701
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Country | US
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Telephone | 530-758-2060
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Fax |
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Provider Business Mailing Address
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Address Line | 981 GOLDFINCH CIRCLE
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City | CONCORD
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State | CA
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Zip | 94520-4832
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Country | US
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Telephone | 650-438-3468
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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 | 83110
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 83110
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 121004
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License Number State | CA
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