Provider Demographics
NPI:1649394792
Name:MAI, NOEMI (LMFT)
Entity Type:Individual
Prefix:
First Name:NOEMI
Middle Name:
Last Name:MAI
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 1:390 N EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4763
Mailing Address - Country:US
Mailing Address - Phone:909-949-6526
Mailing Address - Fax:909-949-7809
Practice Address - Street 1:390 N EUCLID AVE
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4763
Practice Address - Country:US
Practice Address - Phone:909-949-6526
Practice Address - Fax:909-949-7809
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT46357106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist