Provider Demographics
NPI:1114016243
Name:LYNCH-LOFTUS, MAURA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MAURA
Middle Name:
Last Name:LYNCH-LOFTUS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:MAURA
Other - Middle Name:
Other - Last Name:LOFTUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1745 W. ORANGEWOOD, STE. 101
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868
Mailing Address - Country:US
Mailing Address - Phone:714-324-3786
Mailing Address - Fax:714-939-7720
Practice Address - Street 1:1745 W ORANGEWOOD AVE STE 101
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2041
Practice Address - Country:US
Practice Address - Phone:714-324-3786
Practice Address - Fax:714-939-7720
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS144151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical