Provider Demographics
NPI:1114193596
Name:STYS, DANISE RENE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:DANISE
Middle Name:RENE
Last Name:STYS
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 235
Mailing Address - Street 2:
Mailing Address - City:EAST IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92650-0235
Mailing Address - Country:US
Mailing Address - Phone:949-249-4483
Mailing Address - Fax:
Practice Address - Street 1:23181 VERDUGO DR
Practice Address - Street 2:SUITE 104-A
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1357
Practice Address - Country:US
Practice Address - Phone:949-249-4483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38240106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist