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General NPI Number Information
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NPI Number | 1932115268
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Entity Type | Individual
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Provider Name | JEANNETTE QUIROS SAUCEDO LMFT
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Gender | Female
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 11/30/2009
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Provider Practice Location Address
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Address Line | 2030 E 4TH ST SUITE 206 E
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City | SANTA ANA
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State | CA
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Zip | 92705-3940
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Country | US
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Telephone | 714-381-4026
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Fax |
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Provider Business Mailing Address
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Address Line | 16110 ORSA DR
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City | LA MIRADA
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State | CA
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Zip | 90638-4214
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Country | US
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Telephone | 714-381-4026
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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 | MFC41645
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License Number State | CA
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