Provider Demographics
NPI:1316549496
Name:PORTER, AUTERAU SIENNA (AMFT)
Entity Type:Individual
Prefix:
First Name:AUTERAU
Middle Name:SIENNA
Last Name:PORTER
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:AUTE
Other - Middle Name:SIENNA
Other - Last Name:PORTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6602 OLD PACIFIC COAST HWY
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001-9704
Mailing Address - Country:US
Mailing Address - Phone:805-259-8650
Mailing Address - Fax:
Practice Address - Street 1:12722 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-3326
Practice Address - Country:US
Practice Address - Phone:818-672-6033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA119539106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist