Provider Demographics
NPI:1790153526
Name:MASON, ANN MARIE (LMFT)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:MASON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:MARIE
Other - Last Name:FLORY MASON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:1605 N SPURGEON ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-2355
Mailing Address - Country:US
Mailing Address - Phone:714-953-5428
Mailing Address - Fax:714-246-8907
Practice Address - Street 1:1605 N SPURGEON ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-2355
Practice Address - Country:US
Practice Address - Phone:714-953-5428
Practice Address - Fax:714-246-8907
Is Sole Proprietor?:No
Enumeration Date:2015-09-10
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC37590106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist