Provider Demographics
NPI:1225379100
Name:CISNEROS, VERONICA (LMFT #96678)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:
Last Name:CISNEROS
Suffix:
Gender:F
Credentials:LMFT #96678
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27403 YNEZ RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-5603
Mailing Address - Country:US
Mailing Address - Phone:760-419-0584
Mailing Address - Fax:
Practice Address - Street 1:27403 YNEZ RD
Practice Address - Street 2:SUITE 205
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-5603
Practice Address - Country:US
Practice Address - Phone:760-419-0584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-02
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist