Provider Demographics
NPI:1265656292
Name:AMBROSE, SIENNA LOUISE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:SIENNA
Middle Name:LOUISE
Last Name:AMBROSE
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 1:851 S MOUNT VERNON AVE STE 7A
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-3926
Mailing Address - Country:US
Mailing Address - Phone:760-241-6044
Mailing Address - Fax:909-639-7079
Practice Address - Street 1:851 S MOUNT VERNON AVE STE 7A
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-3926
Practice Address - Country:US
Practice Address - Phone:760-241-6044
Practice Address - Fax:909-639-7079
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X
CA52732106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral