Provider Demographics
NPI:1972981082
Name:EKBATANI, MANA (LMFT)
Entity Type:Individual
Prefix:
First Name:MANA
Middle Name:
Last Name:EKBATANI
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 1:8 EGRET LN
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-1759
Mailing Address - Country:US
Mailing Address - Phone:818-430-3141
Mailing Address - Fax:
Practice Address - Street 1:2081 BUSINESS CENTER DR
Practice Address - Street 2:SUITE # 109
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1119
Practice Address - Country:US
Practice Address - Phone:949-407-9590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53508106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist