Provider Demographics
NPI:1083086888
Name:LESTER, LIANE CHRISTINE (MFC 49610)
Entity Type:Individual
Prefix:MRS
First Name:LIANE
Middle Name:CHRISTINE
Last Name:LESTER
Suffix:
Gender:F
Credentials:MFC 49610
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1673 W BROADWAY
Mailing Address - Street 2:SUITE 6
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92802-1109
Mailing Address - Country:US
Mailing Address - Phone:714-774-5915
Mailing Address - Fax:714-774-8095
Practice Address - Street 1:1673 W BROADWAY
Practice Address - Street 2:SUITE 6
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92802-1109
Practice Address - Country:US
Practice Address - Phone:714-774-5915
Practice Address - Fax:714-774-8095
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT49610106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist