Provider Demographics
NPI:1972815637
Name:JAUREGUI, TONETTE MARIE (LMFT)
Entity Type:Individual
Prefix:
First Name:TONETTE
Middle Name:MARIE
Last Name:JAUREGUI
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 1:8432 MAGNOLIA AVE # 142
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-3206
Mailing Address - Country:US
Mailing Address - Phone:951-203-8737
Mailing Address - Fax:
Practice Address - Street 1:7223 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-3812
Practice Address - Country:US
Practice Address - Phone:951-203-8737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-10
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48436106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist