Provider Demographics
NPI:1558396267
Name:WHITNEY, EUGENE LORIN (MDIV, PHD, MFT)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:LORIN
Last Name:WHITNEY
Suffix:
Gender:M
Credentials:MDIV, PHD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26381 CROWN VALLEY PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6368
Mailing Address - Country:US
Mailing Address - Phone:949-582-2492
Mailing Address - Fax:
Practice Address - Street 1:26381 CROWN VALLEY PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6368
Practice Address - Country:US
Practice Address - Phone:949-582-2492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3493106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist