Provider Demographics
NPI:1750948774
Name:PANORAMA MARRIAGE AND FAMILY COUNSELING, A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:PANORAMA MARRIAGE AND FAMILY COUNSELING, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:DELANEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:949-298-6422
Mailing Address - Street 1:12751 PANORAMA PL
Mailing Address - Street 2:
Mailing Address - City:NORTH TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92705-1335
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:242 W MAIN ST STE 105
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-7715
Practice Address - Country:US
Practice Address - Phone:949-298-6422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-24
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)