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NPI Code Detail

MEDICARE: MS. PATRICIA TATENCO-LAGUNA M.A., MFT

MEDICARE: MS. PATRICIA TATENCO-LAGUNA M.A., MFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist84930CA

General Provider Information

NPI Number : 1720282262
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PATRICIA TATENCO-LAGUNA M.A., MFT
Provider Business Mailing Address
First Line : 3200 E GUASTI RD STE 100
Second Line :
City : ONTARIO
State : CA
Zip : 91761-8661
Country : US
Telephone Number : 951-227-3730
Fax Number : 909-259-7004
Provider Business Practice Location Address
First Line : 3200 E GUASTI RD STE 100
Second Line :
City : ONTARIO
State : CA
Zip : 91761-8661
Country : US
Telephone Number : 951-227-3730
Fax Number : 909-259-7004
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2007
Last Update Date : 06/13/2023

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