Provider Demographics
NPI:1467795732
Name:MENESES, ROSA LAURA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:ROSA
Middle Name:LAURA
Last Name:MENESES
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 1:780 SHADOWRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-7986
Mailing Address - Country:US
Mailing Address - Phone:760-807-4271
Mailing Address - Fax:
Practice Address - Street 1:780 SHADOWRIDGE DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-7986
Practice Address - Country:US
Practice Address - Phone:760-807-4271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF81282106H00000X
CALMFT99989106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist