Provider Demographics
NPI:1669966404
Name:DINO, SAMANTHA SEATON (MFT)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:SEATON
Last Name:DINO
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13791 PASADENA ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-7925
Mailing Address - Country:US
Mailing Address - Phone:949-310-9627
Mailing Address - Fax:
Practice Address - Street 1:14751 PLAZA DR STE E
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-2773
Practice Address - Country:US
Practice Address - Phone:949-310-9627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA96979106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist