Provider Demographics
NPI:1851839476
Name:ORANGE COUNTY DEPRESSION & ANXIETY FAMILY THERAPY
Entity Type:Organization
Organization Name:ORANGE COUNTY DEPRESSION & ANXIETY FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCIS-CISNEROS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:657-236-4411
Mailing Address - Street 1:505 S VILLA REAL
Mailing Address - Street 2:117
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-3445
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:505 S VILLA REAL
Practice Address - Street 2:117
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-3445
Practice Address - Country:US
Practice Address - Phone:657-236-4411
Practice Address - Fax:657-236-4747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT51542106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty