Provider Demographics
NPI:1689328510
Name:FRANCO, VANCLEIBER
Entity Type:Individual
Prefix:
First Name:VANCLEIBER
Middle Name:
Last Name:FRANCO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 E ORANGETHORPE AVE.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831-5205
Mailing Address - Country:US
Mailing Address - Phone:714-254-8473
Mailing Address - Fax:
Practice Address - Street 1:1501 E ORANGETHORPE AVE STE 200
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-5205
Practice Address - Country:US
Practice Address - Phone:714-254-8473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-09
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA129071106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist