Provider Demographics
NPI:1497522809
Name:WATKINS, LIANNE MARIE (AMFT)
Entity Type:Individual
Prefix:MISS
First Name:LIANNE
Middle Name:MARIE
Last Name:WATKINS
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43041 CORTE CABRERA
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-3701
Mailing Address - Country:US
Mailing Address - Phone:951-563-6385
Mailing Address - Fax:
Practice Address - Street 1:43041 CORTE CABRERA
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-3701
Practice Address - Country:US
Practice Address - Phone:951-563-6385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA143409106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist