Provider Demographics
NPI:1760047864
Name:SANTOS, ELIZABETH MOVILLA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MOVILLA
Last Name:SANTOS
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:PO BOX 7194
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92863-7194
Mailing Address - Country:US
Mailing Address - Phone:714-584-7733
Mailing Address - Fax:
Practice Address - Street 1:23201 MILL CREEK DR STE 220
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-7906
Practice Address - Country:US
Practice Address - Phone:888-795-4337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-03
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA112682106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist