Provider Demographics
NPI:1578779153
Name:ARNOLD, ANNE B (MFT)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:B
Last Name:ARNOLD
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 1:19732 MACARTHUR BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-2419
Mailing Address - Country:US
Mailing Address - Phone:949-224-5278
Mailing Address - Fax:714-752-0860
Practice Address - Street 1:19732 MACARTHUR BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-2419
Practice Address - Country:US
Practice Address - Phone:949-224-5278
Practice Address - Fax:714-752-0860
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 34382106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist