Provider Demographics
NPI:1942575360
Name:LOUROKIS, MARILIN
Entity Type:Individual
Prefix:
First Name:MARILIN
Middle Name:
Last Name:LOUROKIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10155 COLIMA RD
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-2042
Mailing Address - Country:US
Mailing Address - Phone:626-200-6275
Mailing Address - Fax:
Practice Address - Street 1:1250 E WALNUT ST STE 110
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-1877
Practice Address - Country:US
Practice Address - Phone:626-376-5136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF67150106H00000X
CA110312106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist