Provider Demographics
NPI:1588835961
Name:PALMER, LYNNE M (LMFT)
Entity Type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:M
Last Name:PALMER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 N. PARKCENTER DR
Mailing Address - Street 2:#93
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705
Mailing Address - Country:US
Mailing Address - Phone:714-342-5540
Mailing Address - Fax:
Practice Address - Street 1:111 W BASTANCHURY RD
Practice Address - Street 2:SUITE 1A
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-2522
Practice Address - Country:US
Practice Address - Phone:714-342-5540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-13
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39396106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist