Provider Demographics
NPI:1578882973
Name:GALINDO, JORGE FRED (MA, MFT)
Entity Type:Individual
Prefix:MR
First Name:JORGE
Middle Name:FRED
Last Name:GALINDO
Suffix:
Gender:M
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2192 MARTIN ST.
Mailing Address - Street 2:STE 160
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612
Mailing Address - Country:US
Mailing Address - Phone:714-502-0585
Mailing Address - Fax:949-752-5924
Practice Address - Street 1:2192 MARTIN ST.
Practice Address - Street 2:STE 160
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612
Practice Address - Country:US
Practice Address - Phone:714-502-0585
Practice Address - Fax:949-752-5924
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA#MFC39503106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist