Provider Demographics
NPI:1780897918
Name:WATERS, VERONICA (MS, LMFT)
Entity type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:
Last Name:WATERS
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25552 RHODA DR
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-4669
Mailing Address - Country:US
Mailing Address - Phone:949-521-1177
Mailing Address - Fax:
Practice Address - Street 1:25552 RHODA DR
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-4669
Practice Address - Country:US
Practice Address - Phone:714-455-9225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF52877106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist