Provider Demographics
NPI:1144389974
Name:VISS, VERA (MFT)
Entity Type:Individual
Prefix:
First Name:VERA
Middle Name:
Last Name:VISS
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 1:5855 E NAPLES PLZ STE 301
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-5091
Mailing Address - Country:US
Mailing Address - Phone:949-343-6969
Mailing Address - Fax:
Practice Address - Street 1:5855 E NAPLES PLZ STE 301
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-5091
Practice Address - Country:US
Practice Address - Phone:949-343-6969
Practice Address - Fax:562-597-3563
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 36990106H00000X
CA36990106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist