Provider Demographics
NPI:1396825295
Name:WORLEY, ANN (MFT)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:
Last Name:WORLEY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24100 EL TORO RD STE D
Mailing Address - Street 2:#195
Mailing Address - City:LAGUNA WOODS
Mailing Address - State:CA
Mailing Address - Zip Code:92637-3129
Mailing Address - Country:US
Mailing Address - Phone:949-457-9363
Mailing Address - Fax:
Practice Address - Street 1:515 E 1ST ST
Practice Address - Street 2:#D
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3335
Practice Address - Country:US
Practice Address - Phone:949-457-9363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39095106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist