Provider Demographics
NPI:1437470390
Name:WATANABE, ANN MICHELLE
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MICHELLE
Last Name:WATANABE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 W CERRITOS AVE
Mailing Address - Street 2:BUILDING 4
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-6546
Mailing Address - Country:US
Mailing Address - Phone:714-687-6740
Mailing Address - Fax:714-533-6884
Practice Address - Street 1:160 W CERRITOS AVE
Practice Address - Street 2:BUILDING 4
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-6546
Practice Address - Country:US
Practice Address - Phone:714-687-6740
Practice Address - Fax:714-533-6884
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist