Provider Demographics
NPI:1134323991
Name:CAHN, LORRAINE SUSAN (MFT)
Entity Type:Individual
Prefix:MS
First Name:LORRAINE
Middle Name:SUSAN
Last Name:CAHN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 EMELINE AVE
Mailing Address - Street 2:CHILDREN'S MENTAL HEALTH
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-1976
Mailing Address - Country:US
Mailing Address - Phone:831-454-4916
Mailing Address - Fax:831-454-4916
Practice Address - Street 1:5905 SOQUEL DR STE 600
Practice Address - Street 2:
Practice Address - City:SOQUEL
Practice Address - State:CA
Practice Address - Zip Code:95073-2861
Practice Address - Country:US
Practice Address - Phone:831-331-6417
Practice Address - Fax:831-662-1817
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 22790106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA22790OtherMFT LICENSE