Provider Demographics
NPI:1548594302
Name:PRIETTO, LAUREEN JOYCE (MFT)
Entity Type:Individual
Prefix:MS
First Name:LAUREEN
Middle Name:JOYCE
Last Name:PRIETTO
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 1471
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92781-1471
Mailing Address - Country:US
Mailing Address - Phone:714-478-9431
Mailing Address - Fax:714-731-1971
Practice Address - Street 1:232 W MAIN ST
Practice Address - Street 2:SUITE101
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-7721
Practice Address - Country:US
Practice Address - Phone:714-478-9431
Practice Address - Fax:714-731-1971
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-28
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47391101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health