Provider Demographics
NPI:1578685640
Name:EGUREN, FRANCENE RAQUEL (MFT)
Entity Type:Individual
Prefix:
First Name:FRANCENE
Middle Name:RAQUEL
Last Name:EGUREN
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 1:1107 S PACIFIC COAST HWY
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-4903
Mailing Address - Country:US
Mailing Address - Phone:310-767-9955
Mailing Address - Fax:310-316-3349
Practice Address - Street 1:1107 S PACIFIC COAST HWY
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-4903
Practice Address - Country:US
Practice Address - Phone:310-767-9955
Practice Address - Fax:310-316-3349
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40440106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist