Provider Demographics
NPI:1184657934
Name:VANLEEUWEN, DOROTHEA JEANNETTE (MA LMFT)
Entity Type:Individual
Prefix:
First Name:DOROTHEA
Middle Name:JEANNETTE
Last Name:VANLEEUWEN
Suffix:
Gender:F
Credentials:MA LMFT
Other - Prefix:
Other - First Name:DOREEN
Other - Middle Name:J
Other - Last Name:VANDONK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA LMFT
Mailing Address - Street 1:1128 E 6TH ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-5706
Mailing Address - Country:US
Mailing Address - Phone:951-847-7742
Mailing Address - Fax:951-734-8518
Practice Address - Street 1:1128 E 6TH ST
Practice Address - Street 2:SUITE 7
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-5706
Practice Address - Country:US
Practice Address - Phone:951-847-7742
Practice Address - Fax:951-734-8518
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC21951106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist