Provider Demographics
NPI:1265680896
Name:ROMERO, XIOMARA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:XIOMARA
Middle Name:
Last Name:ROMERO
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 1:2900 BRISTOL ST STE B103
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-5947
Mailing Address - Country:US
Mailing Address - Phone:949-385-3013
Mailing Address - Fax:
Practice Address - Street 1:2900 BRISTOL ST STE B103
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-5947
Practice Address - Country:US
Practice Address - Phone:949-385-3013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA84330106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist