Provider Demographics
NPI:1023568391
Name:HUSEMAN, LIANNA LAUTERIO (LMFT)
Entity Type:Individual
Prefix:
First Name:LIANNA
Middle Name:LAUTERIO
Last Name:HUSEMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17442
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92623-7442
Mailing Address - Country:US
Mailing Address - Phone:562-900-1487
Mailing Address - Fax:
Practice Address - Street 1:3636 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6629
Practice Address - Country:US
Practice Address - Phone:562-900-1487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-10
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF90613101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health