Provider Demographics
NPI:1437473196
Name:KANE, ROSEMARY MAXINE (MFC, CATC)
Entity Type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:MAXINE
Last Name:KANE
Suffix:
Gender:F
Credentials:MFC, CATC
Other - Prefix:MS
Other - First Name:ROSEMARY
Other - Middle Name:MAXINE
Other - Last Name:MATUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CATC
Mailing Address - Street 1:23232 PERALTA DR
Mailing Address - Street 2:SUITE 219
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1443
Mailing Address - Country:US
Mailing Address - Phone:949-306-6565
Mailing Address - Fax:949-495-0492
Practice Address - Street 1:18 TECHNOLOGY DR STE 118
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2310
Practice Address - Country:US
Practice Address - Phone:949-922-4564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-23
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA970117101YA0400X
CA46557106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)