Provider Demographics
NPI:1740422070
Name:FILLIPP, MARILYN J (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:J
Last Name:FILLIPP
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 1:1179 TIMBERGATE LN
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-6666
Mailing Address - Country:US
Mailing Address - Phone:714-403-7207
Mailing Address - Fax:
Practice Address - Street 1:1179 TIMBERGATE LN
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-6666
Practice Address - Country:US
Practice Address - Phone:714-403-7207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 41021101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional