Provider Demographics
NPI:1487196333
Name:MEYERHOF, GRETA (LMFT)
Entity Type:Individual
Prefix:
First Name:GRETA
Middle Name:
Last Name:MEYERHOF
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 1:113 AVENIDA SAN DIEGO
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-3419
Mailing Address - Country:US
Mailing Address - Phone:949-637-0064
Mailing Address - Fax:
Practice Address - Street 1:1211 PUERTA DEL SOL
Practice Address - Street 2:200
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-6306
Practice Address - Country:US
Practice Address - Phone:949-276-3222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC32299106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist