Provider Demographics
NPI:1083046460
Name:SERRANO, NICOLE LORIN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:LORIN
Last Name:SERRANO
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 9266
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91701-8266
Mailing Address - Country:US
Mailing Address - Phone:909-450-7172
Mailing Address - Fax:
Practice Address - Street 1:10601 CIVIC CENTER DR STE 120C
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3878
Practice Address - Country:US
Practice Address - Phone:909-300-5746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-07
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist