Provider Demographics
NPI:1992038657
Name:FLORES, HENRY PLASCENCIA I (MFTI)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:PLASCENCIA
Last Name:FLORES
Suffix:I
Gender:M
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3248 TOGNINALI LN
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95206-6044
Mailing Address - Country:US
Mailing Address - Phone:209-679-8070
Mailing Address - Fax:209-933-9050
Practice Address - Street 1:1149 N EL DORADO ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95202-1305
Practice Address - Country:US
Practice Address - Phone:209-468-2335
Practice Address - Fax:209-468-0525
Is Sole Proprietor?:No
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58725106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist