Provider Demographics
NPI:1225398878
Name:DE LA SERNA, FRANCISCO ROBERTO (LMFT)
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:ROBERTO
Last Name:DE LA SERNA
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 S GLASSELL ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-1919
Mailing Address - Country:US
Mailing Address - Phone:949-371-6463
Mailing Address - Fax:
Practice Address - Street 1:369 S GLASSELL ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-1919
Practice Address - Country:US
Practice Address - Phone:949-371-6463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA96335106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist