Provider Demographics
NPI:1346794690
Name:CERNA, LOUISE OROZCO (MA)
Entity Type:Individual
Prefix:MRS
First Name:LOUISE
Middle Name:OROZCO
Last Name:CERNA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15128 S HARLAN RD # 130
Mailing Address - Street 2:
Mailing Address - City:LATHROP
Mailing Address - State:CA
Mailing Address - Zip Code:95330-9754
Mailing Address - Country:US
Mailing Address - Phone:209-624-0733
Mailing Address - Fax:
Practice Address - Street 1:56 SOUTH LINCOLN ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95203
Practice Address - Country:US
Practice Address - Phone:209-624-0733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-03
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT137552106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist