Provider Demographics
NPI:1326223322
Name:URRUTIA, DEISI DANIELA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:DEISI
Middle Name:DANIELA
Last Name:URRUTIA
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 1:144 S. 'L' STREET
Mailing Address - Street 2:
Mailing Address - City:DINUBA
Mailing Address - State:CA
Mailing Address - Zip Code:93618-3205
Mailing Address - Country:US
Mailing Address - Phone:559-591-6680
Mailing Address - Fax:559-591-6684
Practice Address - Street 1:144 SOUTH 'L' STREET
Practice Address - Street 2:
Practice Address - City:DINUBA
Practice Address - State:CA
Practice Address - Zip Code:93618-3205
Practice Address - Country:US
Practice Address - Phone:559-591-6680
Practice Address - Fax:559-591-6684
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104880106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist