Provider Demographics
NPI:1023326428
Name:STERN, DORINA BETH (MFT)
Entity type:Individual
Prefix:MS
First Name:DORINA
Middle Name:BETH
Last Name:STERN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:DORINA
Other - Middle Name:
Other - Last Name:STERN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:26431 CROWN VALLEY PKWY, #160
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691
Mailing Address - Country:US
Mailing Address - Phone:949-285-6074
Mailing Address - Fax:949-215-5435
Practice Address - Street 1:26431 CROWN VALLEY PKWY, #160
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691
Practice Address - Country:US
Practice Address - Phone:949-285-6074
Practice Address - Fax:949-215-5435
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-20
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49041106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist