Provider Demographics
NPI:1689697567
Name:HOLLAND-FRETZ, LISA (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:HOLLAND-FRETZ
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:MRS
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:FRETZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1125 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3814
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:242 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-7715
Practice Address - Country:US
Practice Address - Phone:714-832-7663
Practice Address - Fax:714-832-7684
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39385106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist