Provider Demographics
NPI:1396213567
Name:FORLENZA, SUMMER (LMFT)
Entity Type:Individual
Prefix:
First Name:SUMMER
Middle Name:
Last Name:FORLENZA
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 1:5195 STEAMBOAT DR
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2876
Mailing Address - Country:US
Mailing Address - Phone:909-247-8380
Mailing Address - Fax:
Practice Address - Street 1:9135 ARCHIBALD AVE
Practice Address - Street 2:UNIT B
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730
Practice Address - Country:US
Practice Address - Phone:909-257-8380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-06
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA109427106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist