Provider Demographics
NPI:1326072794
Name:STANTON, LISA M (LMFT)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:M
Last Name:STANTON
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 1:950 S COAST DR STE 204
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-1778
Mailing Address - Country:US
Mailing Address - Phone:714-916-2111
Mailing Address - Fax:147-769-6363
Practice Address - Street 1:950 S COAST DR STE 204
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-1778
Practice Address - Country:US
Practice Address - Phone:714-925-1060
Practice Address - Fax:714-769-6363
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42379106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist