Provider Demographics
NPI:1609980721
Name:TERRY, LAUREN ALLYSON (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:ALLYSON
Last Name:TERRY
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 E CANYON RIM RD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-4317
Mailing Address - Country:US
Mailing Address - Phone:714-202-4084
Mailing Address - Fax:
Practice Address - Street 1:6200 E CANYON RIM RD
Practice Address - Street 2:SUITE 212
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-4317
Practice Address - Country:US
Practice Address - Phone:714-202-4084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 49819106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist