Provider Demographics
NPI:1538302088
Name:BEAUCHAINE, JOSHUA LAWRENCE (LMFT)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:LAWRENCE
Last Name:BEAUCHAINE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S EL CAMINO REAL
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-4069
Mailing Address - Country:US
Mailing Address - Phone:949-584-5957
Mailing Address - Fax:360-323-7285
Practice Address - Street 1:300 S EL CAMINO REAL
Practice Address - Street 2:SUITE 105
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-4069
Practice Address - Country:US
Practice Address - Phone:949-584-5957
Practice Address - Fax:360-323-7285
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA83464106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health