Provider Demographics
NPI:1184081531
Name:MARSHALL, XENIA (LMFT)
Entity type:Individual
Prefix:MS
First Name:XENIA
Middle Name:
Last Name:MARSHALL
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 1:36 HARMONY
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-0920
Mailing Address - Country:US
Mailing Address - Phone:714-328-1158
Mailing Address - Fax:
Practice Address - Street 1:731 S HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-2753
Practice Address - Country:US
Practice Address - Phone:714-446-5288
Practice Address - Fax:714-449-0726
Is Sole Proprietor?:No
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 50533106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist