Provider Demographics
NPI:1578874285
Name:HOENIG LUM, CELIA LYNNE (MFT INTERN)
Entity Type:Individual
Prefix:MS
First Name:CELIA
Middle Name:LYNNE
Last Name:HOENIG LUM
Suffix:
Gender:F
Credentials:MFT INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:674 COUNTY SQUARE DR
Mailing Address - Street 2:SUITE 307
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-5454
Mailing Address - Country:US
Mailing Address - Phone:805-654-1840
Mailing Address - Fax:805-650-8211
Practice Address - Street 1:674 COUNTY SQUARE DR
Practice Address - Street 2:SUITE 307
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-5454
Practice Address - Country:US
Practice Address - Phone:805-654-1840
Practice Address - Fax:805-650-8211
Is Sole Proprietor?:No
Enumeration Date:2010-06-28
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF53887106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAIMF53887OtherBOARD OF BEHAVIORAL SCIENCES