Provider Demographics
NPI:1407845365
Name:GREEN-ALTER, LYNDA (MFT)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:
Last Name:GREEN-ALTER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:LYNDA
Other - Middle Name:DEE
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MARRIAGE & FAMILY TH
Mailing Address - Street 1:4 VENTURE STE 230
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-7375
Mailing Address - Country:US
Mailing Address - Phone:949-453-9600
Mailing Address - Fax:949-453-9601
Practice Address - Street 1:4 VENTURE STE 230
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-7375
Practice Address - Country:US
Practice Address - Phone:949-453-9600
Practice Address - Fax:949-453-9601
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT32950106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist