Provider Demographics
NPI:1477032670
Name:FURST, BRETT (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:FURST
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2876
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92690-0876
Mailing Address - Country:US
Mailing Address - Phone:949-829-3772
Mailing Address - Fax:
Practice Address - Street 1:3197 AIRPORT LOOP DR STE B
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-3424
Practice Address - Country:US
Practice Address - Phone:949-829-3772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA108254106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist