Provider Demographics
NPI:1831842269
Name:OLIVERIA, LALAINEMAE CORVILLA (LMFT)
Entity type:Individual
Prefix:MRS
First Name:LALAINEMAE
Middle Name:CORVILLA
Last Name:OLIVERIA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:LALAINE
Other - Middle Name:
Other - Last Name:VILLAFANA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2135 VINTAGE PL
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92027-1212
Mailing Address - Country:US
Mailing Address - Phone:760-310-3150
Mailing Address - Fax:
Practice Address - Street 1:4141 PACIFIC HWY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-2030
Practice Address - Country:US
Practice Address - Phone:619-393-2003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA119826106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist