Provider Demographics
NPI:1508066101
Name:CUTHBERTSON, DENSIE K (MFT)
Entity Type:Individual
Prefix:MS
First Name:DENSIE
Middle Name:K
Last Name:CUTHBERTSON
Suffix:
Gender:F
Credentials:MFT
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 7752
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92607-7752
Mailing Address - Country:US
Mailing Address - Phone:949-697-1199
Mailing Address - Fax:949-234-1122
Practice Address - Street 1:3551 CAMINO MIRA COSTA
Practice Address - Street 2:STE. K
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-3508
Practice Address - Country:US
Practice Address - Phone:949-697-1199
Practice Address - Fax:949-234-1122
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-21
Last Update Date:2007-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC44172106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist