Provider Demographics
NPI:1164063491
Name:NOBLE'S MARRIAGE AND FAMILY THERAPY
Entity Type:Organization
Organization Name:NOBLE'S MARRIAGE AND FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPY
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOBLE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:949-212-6383
Mailing Address - Street 1:30900 RANCHO VIEJO RD STE 140245
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-1762
Mailing Address - Country:US
Mailing Address - Phone:949-212-6383
Mailing Address - Fax:949-216-5674
Practice Address - Street 1:30900 RANCHO VIEJO RD STE 140245
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-1762
Practice Address - Country:US
Practice Address - Phone:949-212-6383
Practice Address - Fax:949-216-5674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health