Provider Demographics
NPI:1225161367
Name:MINTZAS, CASSANDRA MANUELA (LMFT)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:MANUELA
Last Name:MINTZAS
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 582
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901-0015
Mailing Address - Country:US
Mailing Address - Phone:530-379-5688
Mailing Address - Fax:530-673-1955
Practice Address - Street 1:1133 GRAY AVENUE SUITE B
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-2620
Practice Address - Country:US
Practice Address - Phone:530-379-5688
Practice Address - Fax:530-673-1955
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106667106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist